It’s almost as if homebirth advocates are trying to advertise their moral bankruptcy. They couldn’t care less how many babies die at homebirth, why they die at homebirth and who pretends to be a midwife.

I suppose I shouldn’t be surprised since this is a crowd that has spent years desperately hiding (or when exposed, ignoring) the hideous homebirth deaths rates in Oregon, Colorado and in MANA’s own database. Homebirth midwives have always valued their freedom to “practice” over the lives of innocent children, but this is a new low, even for them.

I’m referring of course to the case of Rowan Bailey. She allegedly represented herself as a licensed midwife even though she uncredentialed and unlicensed. She has been jailed for allegedly presiding over an intrapartum death at homebirth that occurred in July. *Initially it appeared that she allegedly presided over a second intrapartum death in February, but the newspaper has issued a correction stating that the death occurred in July and was reported to the police by the State Medical Board on February 7. In addition, she was arrested last month for prostitution. What are other homebirth midwives doing in response? They’re raising money to “free” her, of course.

Over they years I have written about dozens of preventable homebirth deaths involving mind boggling incompetence on the part of homebirth midwives. Inevitably homebirth advocates parachute in to the blog to insist that the midwife in question was a “rogue” midwife and not representative of homebirth midwives as a group. It appears that you cannot be more of a “rogue”than Rowan Bailey, yet I have seen no midwifery organization, no midwives and no “birth workers” of any kind calling for her to be investigated, and if warranted, held accountable for malpractice.

Wednesday, March 27, 2013, a friend, teacher, mentor, and fellow midwife, Rowan Bailey, as we know and love her was arrested for murder in Asheville, NC. North Carolina prohibits the practice of midwifery by traditional community midwives and CPM’s

In case you were wondering, they couldn’t care less what she did, who was hurt, and whether her actions led to the deaths:

At this time, the details of the case are not available until we have more input from Rowan’s attorney.

It doesn’t matter what happened. All that matters is the issue of human rights:

The way we birth is a HUMAN RIGHTS issue and we must embrace it with compassion, love, and responsibility.

Wrong! The right of a baby who begins labor alive to be born alive may be a human right. There is no human right to represent yourself as a midwife when you are uncredentialed and unlicensed. There is no human right to get your birth junkie fix while letting babies suffocate to death. There is no human right to escape accountability for actions that hurt others. It is morally grotesque to pretend that there are any such human rights.

Bailey has no shortage of supporters. Here’s a look at the Twitter feed soliciting support:

The behavior of these supporters is nothing short of disgusting. They’re raising money to “free” an uncredentialed, unlicensed “midwife” who is charged with misrepresenting her qualifications to parents, presiding over a homebirth death, and who was arrested for prostitution, without making an attempt at, indeed without even calling for an investigation of any kind. Why? Because they think their “freedom” to entertain themselves at births and get paid for it is more important than whether babies live or die.

We can thank these supporters for one thing, though. They have made it crystal clear that they are morally reprehensible in addition to being unfit to care for pregnant women. Rowan Bailey is an object lesson in why North Carolina should never license homebirth midwives. They are ignorant, dangerous and utterly unconcerned about whether babies live or die.

Bailey’s supporters should be ashamed of themselves, but that’s not likely. If you’re willing to ignore dead babies, then you’ve already broadcast the fact that you have no shame.

Thank you so very much for your rational leadership and sponsorship of this forum. You are saving lives.

I have just become aware of the burgeoning retro trend of unregulated and underregulated “doulas” who have absolutely no board certified medical or licensed/registered nursing credentials. Some of the online ads, anecdotes and testimonials are terrifying: actively targetting and recruiting former c-section patients, promoting at worry free at home-birthing exerience for $1000, proudly advocating and directing pushing as “natural” when dilated to 6, 7, or 8, never warning them about the risks to mother and infant when attempting TOLAC or more frequently VBAC (http://emedicine.medscape.com/article/272187-overview), and then often accompanying them to hospital emergency rooms in ambulances with maternal edema, traumatized birth canals, bladders, and ripped uteruses, disappointed their clients didn’t prove their womanhood by sticking it out another 24 hours. The horrors begin to stack up as did those of illegal abortion clinics in the late 1960s! Yes, involuntary manslaughter is murder!

I am confident the vast, vast majority of these folks are wonderful, loving, well-intentioned and the majority of home procedures are successful. Some are even licensed health professionals or massage therapists who have studied biology, physiology and nursing medicine. But the capacity to perform an emergency C-section to save a life or prevent anoxic brain injury in a baby hung up in a birth canal, not. There appears to be a great need for higher professional certification and licensing requirements, as well as mass scale education of the risks when things go wrong, which they quite often do in childbirth. This goes well beyond a guild issue, a natural versus western medicine debate, a “good /successful mother versus bad/failure mother” posturing. Life/death/ consumer protection and the need to harmonize standards and regulations of a trade that has the potential to cause tremendous harm to the most innocent of human life. Does any state have a model regulatory or statutory code? I have found nothing in Tennessee for “doulas” or “monotrice”. Thanks.

Thank you for sharing your story. I am so sorry for your loss. That midwife was criminally irresponsible, and never should have made promises like that that she couldn’t keep.

Perhaps the “Hurt by Homebirth” blog will want your story, if you are willing to share it further.

I don’t have a creative name

I remember your story. I think I saw it on Baby Center. I am so so sorry for the loss of your precious baby girl. You are not alone here. There are a number of mommies who post here who sadly are in the same situation, who were lied to by the homebirth movement and told it was safe, when it will never be safe, even under the best circumstances.

I hope you can find some support here and some healing.

Dreah Louis

I don’t support Home Birth anymore. I did before I lost a twin due to midwife being 2 hours late. Ive been ridiculed since then for choosing to birth at home. License or not I don’t think women should birth at home. To much can go wrong and if you don’t have the right equipment in the right time baby will not surivie

Beck

I know! No baby’s ever died in a hospital…oh, wait, they have. bitch.

KarenJJ

An insult and a common rebuttal we’ve heard many times before. Anything else you care to add? Why shouldn’t a negligent midwife face charges for poor care that leads to a death? Reading some of the comments below, she’s not got a lot of support from the local midwives either.

Beck

Because Rowan (Tina) was extremely attentive and was constantly checking my vitals and stuff during my home birth. I also happen to know for a fact that she did hands on training at over a hundred natural births with an experienced midwife before doing any on her own. I would choose an experienced midwife over a book-studied doctor any day. And also, as far as death rates go, read this article.

And despite what others have said about my math, in Australia it says that there were 20 deaths in planned hospital births, and ONE at a homebirth last year. I apologize for namecalling, but I am extremely mad at all the lies going around about both Rowan and homebirth. I did have slight complications in the hospital…but the nurse-midwife there CAUSED them. She chose to pull out my afterbirth rather than me stand and push it out, and tore a piece off by accident and left it inside me. I found it and got it out 2 DAYS later. My homebirth with a regular midwife went flawlessly, with her instructing me to stand and push it out, taking ALL the afterbirth with it. Rowan was a little surprised they actually overlooked it.

ratiomom

Only one homebrith death in Australia last year? I don`t think so. Google `Lisa Barrett`, This gem of a midwife has single-handedly killed 4 healthy term babies and given at least one permanent brain damage. That`s four tiny white coffins and four devastated families for you, all perfectly avoidable.

http://www.facebook.com/profile.php?id=100002171364303 Anj Fabian

errata: Lisa Barrett’s trail of tiny coffins stretches over several years

As for home birth deaths, at least one home birth death last year was a maternal fatality – Caroline Lovell. She had the midwives and everything. She’s still dead. Her husband is still a widow. Her children are still motherless.

Dr Kitty

You know Drs will see more births in a month than a midwife will in years? I’m not entirely sure your point that Doctors are less experienced than midwives holds water. E.G. I saw 10 births in ONE WEEK as a medical student.

Also- you are in error about controlled cord traction- which is used to remove a placenta WHICH HAS ALREADY DETACHED FROM THE UTERINE WALL through the cervix.

It is done because a placenta which has detached but is stuck in the uterus prevents effective contraction of the bleeding vessels and increases the risk of PPH. It is highly unlikely your MW tore the placenta with CCT- rather it is more probable that the placenta simply didn’t properly separate in one piece (that is if it was a piece of retained placenta at all, and not just a big clot).

Gravity alone is often not enough to expel a placenta and CCT is proven to be both safe and effective.

Personally, I wouldn’t take “Rowan’s” surprise as evidence of anything other than her ignorance.

Beck

First of all, it WAS a part of the waters. It was semi-clear, and about 7 inches squared when I peeled it apart. It was ATTACHED to a clot which I got off of it. (Call me a freak, but I got kind of interested in it when I finally dislodged it). And also, my cousin was watching (she was my doula), and she SAW it tear off of the rest of what the MW pulled out. She just assumed that the midwife went back in and got it out a minute later, since I had needed her and she wasn’t able to watch any longer.

I have a family member who had all 6 of her children in a hospital, and with one of them, the doctor completely forgot about all of the afterbirth and she almost died because it was neglected. Fortunately for her she noticed it several days later and quickly had it removed.

On a final note, when I stood and pushed out my placenta the first time, everything came out, bounced on the floor, off the dresser and back to the floor…Yes, i know, TMI, but you can’t convince me gravity and pushing won’t expel it…because it went FLYING….LOL

I’m not saying hospital birth shouldn’t exist, because i believe in options, and that if a woman wants to opt for a hospital, more power to her, and some women NEED it due to health problems. I’m just saying that home birth IS natural and safe for those of us who choose it. And it is a God-given right to birth how we choose, and nobody has the right to take that away.

Let’s take your inaccurate numbers at face value and do some math. OK, 20 deaths in one year in hospitals, and 1 at home. Keep in mind that home births in Australia are less than 1% of all births. Let’s go with 1%. That means for every home birth there are 99 hospital births. (It’s really more than that.) Let’s get the ratio of these death rates. 1 homebirth death / 20 hospital deaths * 99 hospital births / 1 home birth = a relative death rate of 4.95 deaths at home birth for every death in a hospital.

What does this mean? If ALL births were done at home, you’d have five times as many dead babies than you’d have when compared to ALL births done in a hospital.

The absolute number of deaths is far less relevant when you are looking at safety. The RATE of deaths is what matters, and is what you can meaningfully compare.

Lovely. These are the same people arguing that a natural birth makes for a more peaceful world?

http://www.coffeebeings.blogspot.co.uk/ Coffeebeings

I’ve had one wonderful hospital birth, resulting in the birth of twins, and two beautiful homebirths. All three experiences have been very different, but each time I’ve been looked after and supported by amazing people. I do think women should have the choice to give birth at home with a medical professional if that’s what they prefer. The difficulty in the US appears to me to be the lack of a suitable system enabling homebirths. Here in the UK, all midwives undergo the same medical training and are the primary healthcare professionals during most hospital births –doctors don’t often even get a look-in. If women choose, they can have their birth take place at home with those same midwives, or at a “midwifery-led unit”. The US appears to be, as usual, very polarised about all of this. It’s the midwives vs the medical system, the bad doctors, etc. The physiological birthers vs the medical birthers. I can’t see anyone coming to an agreement, though; instead it seems that everyone’s goal seems to be to convince everyone else about how “right” their opinion and “stats” are. How sad. The world is so much more grey than you’re allowing it to be.

Eddie

instead it seems that everyone’s goal seems to be to convince everyone else about how “right” their opinion and “stats” are.

While there are people doing what you say, there are also people working to change the system in the US to require a higher degree of training before someone can call themselves or act as a midwife. There are also people working to change the hospital system to be more accommodating.

The hospital my wife had our youngest at was highly accommodating. Hospitals obviously want the business, and I’m sure they’d prefer it not arrive via the ER. They’re figuring out — at least in some parts of the US — what mothers and families want, and figuring out how to provide that.

http://www.facebook.com/profile.php?id=100002171364303 Anj Fabian

“I do think women should have the choice to give birth at home with a medical professional if that’s what they prefer.”

First, women should have the OPTION, not the choice. If no HCP is willing to attend someone’s HB, the woman can’t coerce her choice of HCP to attend.

Secondly, in the states, the bona fide medical professionals that will attend home births are CNMs. The non-CNM midwives who may encourage any and all women to HB are not medical professionals.

http://www.coffeebeings.blogspot.co.uk/ Coffeebeings

“If no HCP is willing to attend someone’s HB, the woman can’t coerce her choice of HCP to attend.”

Exactly. And that’s why I said there is a lack of a suitable system enabling homebirths in the US!! My sister lives in a state where only CNMs are allowed to attend homebirths. She did her research and found no CNM willing to attend a HB. Because there is a lack of a suitable system enabling homebirths for those who prefer them, women feel they do not have any option but to give birth in hospital.

theNormalDistribution

I don’t understand.. What is your proposed solution to this problem?

http://www.coffeebeings.blogspot.co.uk/ Coffeebeings

I don’t understand what it is you don’t understand. My personal proposed solution would be to stay here in the UK until I finish having children, in a more relaxed, open-minded society that is less uptight about birth and in which the medical system easily accommodates and facilitates home births.

Lost in Suburbia

OT – Dr. Amy, is there something up with the formatting on your site? I’ve noticed for several weeks that on posts where there are a lot of comments, that the comments at the bottom of the page are gray text on a black background, while the text above is on a white background. Annoyingly hard to read the comments below. I’ve seen this on at least two different devices – one desktop, one mobile.

Alenushka

Here is HMW who provides prenatal care while her sex offender husband babysits the kids of her patients. It is all in the comments.

What about the babies that are murdered in abortion clinics do they not have a right to be born as well? Sometimes babies die during delivery. I know it is sad and not something we like but it has happened for centuries. It is a result of sin in our world death, disease, and destruction are all a part of this. But what about the doctors that intentional murder babies in abortion mills? They should be arrested as well.

AllieFoyle

Um, I was going to type out an earnest reply to your comment, but on second thought it’s probably better to just point out that not everyone believes that death and disease are the result of sin or that legal abortion of an embryo well before viability is in any way equivalent to the unnecessary death of a baby at or near term.

Guestll

April Fools was yesterday, Carmen.

esteeha

Carmen, I’m with you.Unfortunately, in this world it all comes down to whether the unborn child is wanted or not wanted. It’s sad. I think this blog post says it best: “It is illegal to take the life of the unborn if the mother wants the baby, but it is legal to take the life of the unborn if she doesn’t. In the first case the law treats the fetus as a human with rights; in the second case the law treats the fetus as non-human with no rights.

Where do non-viable, badly wanted pregnancies fit into your cut-and-dried worldview? What are the rights of the mother who will die unless her ectopic pregnancy is ended?

What were the rights of my son, who would have been born missing most of his skull, unable to suckle, incapable even of being held by his mother, a life lived for maybe minutes, all of those infinitesimal seconds spent in terrible pain?

Humanness, to me, is defined by kindnes, and the ability to demonstrate strength of character under duress. Unless you’ve walked a mile in my shoes or walked with me with love on that walk, you have no business weighing in.

KumquatWriter

You are forgetting moved, wanted babies that are aborted because of various birth defects that would kill or severely damage them. I would have been sent to Dr. Tiller, had he not been murdered two weeks before my son’s condition was discovered.

Your story is beautifully written. I’m so sorry for the loss of your beautiful son.

http://www.facebook.com/profile.php?id=613905265 Bambi Chapman

This has NOTHING to do with abortion at all. The two are completely different.

BeatlesFan

Right, so because some doctors perform abortions (done with the mother’s consent, and usually before 12 weeks gestation) that means that there is absolutely no reason to prosocute anyone whose actions (or inactions) result in the death of a full-term, viable baby? Hint: one of those things is a medical proceedure, which the mother gives consent for; the other is negligent homicide.

Captain Obvious

I think this baby was a wanted baby. Women who have abortions are unplanned or not desired. Quite different.

http://www.facebook.com/profile.php?id=100002171364303 Anj Fabian

You know what else has happened for centuries?

Just about everything. The difference between then and now is that we can PREVENT the deaths of wanted babies.

Of course, we actually have to WANT TO prevent those deaths. Some People seem to not care if a baby lives or dies – only if one their Tribe suffers any of the consequences of their in/actions.

suchende

“Murder” is a legally defined term. Feticide is not murder in the US, nor is it murder as defined in the Bible (instead, causing the demise of a fetus is treated as a lesser crime than murder). Please do not misuse terms.

http://www.facebook.com/lizzie.dee.71 Lizzie Dee

It may be treated as a lesser crime, but I don’t see that it is, always. To leave a child who is maybe minutes away from a long life struggle and die so that the mother can feel pleased with her performance is some kind of a crime, whether it comes from idiocy or indifference.

suchende

“It should be murder” is different than “is murder.” Not every killing is a murder; that is why we have the concept of manslaughter. You can’t just substitute meaning for a legal term because of your personal view. Let’s take another example: someone goes to Vegas and loses their shirt at the blackjack table, then says “I was burlarized by the Venitian!” The gambler may feel his money was wrongly separated from him, but it’s incorrect to call it burglary. Similarly, the “abortion is murder!”
crowd may feel that abortion is a wrongful killing, but murder? It just isn’t.

http://www.facebook.com/lizzie.dee.71 Lizzie Dee

Agree with all of that. It doesn’t make sense to call willful or careless negligence murder. But laws change with circumstances, and some of these people should be able to be charged with something that puts them permanently out of business, not turns them into martyrs.

Dr Kitty

Why “should” they be arrested?
Have they broken the law?
No?
Well then.

I do not get why negligently causing an intrapatrum term stillbirth gets a shrug and “oh well, fall of man and all that, too bad” but performing a legal and possibly life saving medical procedure with the woman’s consent is something that justifies a prison sentence and opprobrium.

http://twitter.com/Stepuhhnie Stepuhhnie

If you looked and didn’t generalize for the whole home birth movement, you’d see there are plenty of people not willing to help. I recognize your hate for those that favor home births, but it’s attitudes like yours, from providers, that make people more likely to put themselves in a home birth situation.

Most doctors push unnecessarily for interventions. Things like pitocin, episiotomies and c-sections are HORRIBLY overused. If I knew a doctor that would confidently say they don’t push for induction since a due date is an estimate, wouldn’t require I labor in bed due to monitoring, I would be allowed to eat and drink, try not to perform episiotomies, and they wouldn’t rush the natural process because they’re impatient (like manually removing a placenta, for one), I’d gladly let them deliver my baby. But how often do you find that? In Europe and Latin America, sure, you can find that…here? Not so sure. And this hateful attitude towards people who wish to have a natural, uncomplicated birth without interventions is why these mothers are reluctant to use OB/GYNs.

I would never endorse using an unlicensed provider (and it’s ridiculous to raise funds for someone who illegally practices), and I can’t say I’m comfortable with the CPM model either, but fear does a lot, especially when you’re forced into procedures or the doctor rushes a natural process. I work with surgeons on a daily basis, I know how they can push for surgery when it’s not the only option or last option. OB/GYNs are surgeons. End of story.

The Bofa on the Sofa

Most doctors push unnecessarily for interventions.

How have you determined which interventions are necessary and which are not?

I don’t have a creative name

I would REALLY like to see an answer for this question. For real. 20 bucks it begins with the word “most”.

The Bofa on the Sofa

Oh, I am so disappointed that Stepuhhnie has not stuck around long enough to address everyone’s comments. Not surprised, of course, but disappointed.

Eddie

Stepuhhnie and bela both. Agreed. People complain that their point of view is not represented here, then they don’t stick around to argue it. I’m not sure I should be disappointed, exactly, but …

The Bofa on the Sofa

Oh I am definitely disappointed. I wanted to see Stepuhhnie have a meltdown. She sure as hell wasn’t going to contribute to a rational discussion, but I was hoping for some entertainment.

http://twitter.com/Stepuhhnie Stepuhhnie

Sorry, have this thing called a job!

Gene

How many OBs do you know? How many births have you witnessed or been part of IN A HOSPITAL? I ask these questions genuinely. I was up and walking around during labor, both before and after an epidural was placed. Even eating (oreos cookies…). I know quite a few OBs and their entire goal is a healthy mom and healthy baby. Completely “intervention” free births happen all the time in hospitals that are attended by those evil doctors. The point of an intervention is to do something when things ARE NOT GOING WELL. Your water breaks and you don’t go into labor within 24 hours, you AND YOUR BABY are at increased risk on infection and death – so induction is indicated. Episiotomies are not routine. Manual placental removal is done only when if has not detached on its own (another infection risk).

I don’t understand why HB supporters are deaf to this: NATURAL, INTERVENTION FREE BIRTHS HAPPEN IN HOSPITALS EVERY DAY IN THE US.

Eddie

I don’t understand why HB supporters are deaf to this: NATURAL, INTERVENTION FREE BIRTHS HAPPEN IN HOSPITALS EVERY DAY IN THE US.

Yes, THIS. My understanding, however, is that this varies quite widely, depending on the hospital. Some who works with a particularly “intervention-happy” hospital might think the whole system is like that. It is not.

Also, as you say, these interventions are done for actual reasons — valid reasons (reduced chance of fetal death) and invalid ones (by which I mean no improved outcomes. Such as fear of malpractice lawsuit).

The Bofa on the Sofa

When we were in baby class, I asked the instructor why she didn’t do more breathing exercises. She says that 90% of the moms just do an epidural anyway, so it’s not worth it.

OK, let’s go with that. That hospital does about 100 births a month. Assuming that 30% of the babies are born by c-section, that means there are 70 vaginal deliveries. If 90% have eipidural, that means that there are about 7/month that don’t, or one or two a week. That’s in a small hospital.

So even with a 90% epidural rate, the staffs in these small hospitals are doing around 7 non-medicated deliveries a month, which is twice as much as you get for a midwife.

One of the OBs at this hospital will deliver about 350 babies a year. If 30% are c-sections, and 90% get epidurals, that means they still are seeing a non-medicated birth probably once ever other week, or twice a month. Is that really so much less than a midwife doing 3 deliveries a month?

Bombshellrisa

And if they do work at a hospital where there is a high rate of inductions and C-sections, why is that? Is it the only hospital in the area with a level 3 NICU? Is it where all the high risk women deliver?

Eddie

Right. Just because one hospital has twice the C-Section rate of another does not mean they are overused. You have to know more about what is going on.

Bombshellrisa

I hope that down vote was an accident-how ironic would it be to have an “educate yourself” troll vote down a comment that suggests research might glean understanding

Eddie

Looking at that thread, someone systematically downvoted most every post it looks like. Disappointing and immature, but so it goes.

Bombshellrisa

Yeah, we are MEEEN and “spew” poison and vitriol and who knows, we are all pagan intervention worshippers from the sound of things. Carry on.

Eddie

The so-called hateful attitude you find here is not directed and those who choose a home birth. It’s directed at those who falsely claim to be expert at it and “assist” those who choose a home birth.

It’s understandable to want a “natural, uncomplicated birth without interventions,” although my wife VERY much wanted (and got) an epidural. But she was able to walk around up until the moment she got the epidural, even with monitoring. She had no episiotomy. She *was* induced, but that was *many* hours after her water broke and labor had hardly started. We had the choice to refuse, of course.

If you want to have a clue why doctors push so many interventions, just look at the rate of malpractice lawsuits. I know that our Ob/Gyn got paid the same no matter what kind of delivery occurred, so money is not a motivation to do unnecessary procedures. Dr Amy agrees with you that too many C-Sections are done in America. (Last night I read some of her first columns on this site.)

http://twitter.com/Stepuhhnie Stepuhhnie

I agree that interventions are pushed for malpractice reasons. It’s unfortunate that people are sue-happy. I do think though, that it’s unfair for practicing to be reigned by the fear of malpractice.

Karen in SC

I teach chemistry lab in a warm climate. My students prefer to wear flip flops but I don’t allow them to participate until they go get shoes. They don’t think that it is fair at all. They won’t spill chemicals or break glass. Why can’t they have a “natural lab experience.” (note I also require splash goggles).

It all goes to the standard of care, not just malpractice. If there is an injury, I wouldn’t have any logical defense, would I? Same for the medical field, you are a patient and deserve a standard of evidence based care. And there is no crystal ball, unfortunately.

Bombshellrisa

” this hateful attitude towards people who wish to have a natural, uncomplicated birth without interventions is why these mothers are reluctant to use OB/GYNs.”
Nobody can choose to have an uncomplicated birth. They can write their ideal birth scenario down (aka the birth plan), but they can’t force their bodies to adhere to it. Dr Amy was lucky in that she was able to have those uncomplicated births, but educated enough to know that not every woman can labor and deliver like she did.
The term “natural” is horribly overused. Cancer, renal failure and complex fractures are also part of the natural process, I have yet to see as many people insist that we deal with these things without interventions.

http://twitter.com/Stepuhhnie Stepuhhnie

Wow, comparing cancer to child birth? That’s nothing near the same. Cancer treatment is harsh, knowingly, and there’s always the risk for re-occurrence. Many women will have more than one child and to compare it to something deadly is nonsensical.

Bombshellrisa

I was not talking about treating cancer. Treatment is intervention.

Eddie

Do you understand that before modern medical interventions, that each childbirth had a 1% chance of the mother dying — in America? After 1900. That about 25% of women who died during childbearing years died in childbirth or complications thereof?

Bombshellrisa

I know what is going to happen next-there is going to be a comment about handwashing or some such talk of hygiene. Like handwashing can prevent pre-e, GBS or GD.

Here is my anecdote – having cancer was easier than the dramatic birth of my first child. In delivery I almost lost my baby and was in danger myself but the cancer was removed with little to no fanfare and the recovery was far easier. Bombshellrisa was saying both are natural and both can kill you. And that is true.

Haelmoon

All of my pregnancies almost killed me. I wanted normal unmedicated births, preferably vaginal. I was healthy and had not known risk factors (other than being an obstetrical resident, if you count that)

My first was a complicated pregnancy with a smaller than average baby. Membranes broke at 32 weeks, she was a footling breech and prolasped her cord. Modern medicine saved both of us – emergency C-section, and if I had a long labour with a dead baby, I would have been at significant risk.

Number two complicated by abruption, PPROM and chorioamnionitis. My son and I were treated with antibiotics, and recovered without incident. He delivered at 33 week.

Number three – failed modern medicine, the IUD didn’t work and we had a little surprise!! Chronic abruptions, significant antepartum bleeding leading to TWO transfusions, at 25 weeks and 27 weeks. Also PPROM and a surprise breech vaginal delivery at 29 weeks.

So yes, pregnancy can be like cancer. It is natural, but you can’t always prevent it. It can kill you, but medicine might just save you. On a truly medical point, the placenta can be very cancer-like. I did a c-hyst this week for a percreta, which is VERY cancer like if you ask me. Last week I treated an ectopic with methotrexate, a chemotherapy agent.

I actually think is a reasonable comparison.

p.s. I don’t push unnecessary interventions, I talk to my patients, review the facts and give them options. My favourite type of delivery is a vaginal one, without my assistance!!

Eddie

So yes, pregnancy can be like cancer

To this point, a friend of mine in college was delighted to be pregnant, but had a miscarriage. Then discovered she had “cancer.” It was some trisomy disorder and the fetal cells continued to divide inside her body. Just as they were about to start chemo, her hormone numbers finally started to drop. This pregnancy quite literally became cancer.

I don’t have a creative name

“Most doctors push unnecessarily for interventions.”

Once again, an entire post built around a sentence that begins with the word “most”, with NOTHING to prove it or back it up.

http://twitter.com/Stepuhhnie Stepuhhnie

I didn’t know I was writing a thesis that needed sources. If I weren’t actually working, I would have taken longer to write my response for you, works cited page and all.

I don’t have a creative name

You respond with sarcasm because you have nothing else. Your claims of “most” this or “most” that are based on nothing but your own opinion, which means nothing.

Bombshellrisa

No-just a link to your source material.

auntbea

“Things like pitocin, episiotomies and c-sections are HORRIBLY overused”

Says who? And why should we believe them?

moto_librarian

Um, you do realize that the episiotomy rate in the United States is approximately 10%, right? There was a time when routine episiotomies were done because they were thought to prevent worse tears. When the evidence did not support this, the practice of routine episiotomy ended.

If a woman has an epidural, she will likely labor in bed (unless she has a walking epidural). I guess I don’t see why this is a problem. For my first (unmedicated) birth, I did all of the walking that I wanted, plus a ton of different laboring positions, none of which were particularly effective for managing the amount of pain that I was in. With my second, I enjoyed several hours of sleep thanks to a beautiful epidural.

I’ve given birth in a hospital twice, and frankly, I think that you don’t know a damned thing about hospital birth. You have filled up my NCB bingo card with all of the usual myths about hospital births. Try getting some current information before parachuting in here to “educate” us, ‘kay.

Eddie

When the evidence did not support this, the practice of routine episiotomy ended.

Here is the most important thing that Stepuhhnie needs to understand. What happens in delivery rooms is not static.

The Bofa on the Sofa

Um, you do realize that the episiotomy rate in the United States is approximately 10%, right?

Of course she doesn’t. She doesn’t have the first clue.

http://twitter.com/Stepuhhnie Stepuhhnie

Thanks for speaking for me!

In my state the episiotomy rate is 15.7%, higher than the national average. In the city, specifically, it’s higher for many hospitals, some being up to 25%.

Rabbit

15% of all women delivering, or 15% of those delivering vaginally? Even assuming it is all women, and assuming that women having c-sections don’t also get episiotomies, and the c-section rate is around 30%, that means that over half of the women do not receive an episiotomy. A far cry from your initial you-can’t-find-any-doctor-who-doesn’t-do-them-to-everyone position.

http://www.facebook.com/profile.php?id=613905265 Bambi Chapman

The last time I had a DR give me an automatic episiotomy, it was 2000, so 13 years ago.

http://twitter.com/Stepuhhnie Stepuhhnie

I’ve had many friends still getting them to date.

Eddie

The United States is a large country. Medical practices are far from uniform. It sounds like you’re in an area that does more episiotomies than the national average, which means your area is not representative of the country.

Karen in SC

I had one too, and it didn’t diminish anything, healed well and I still have sex! It’s a miracle!!! Alert the media!!! PS vaginal tears can be very awful, down to the rectum. Episiotomies might just help some mothers get the vaginal birth they want (instead of surgery). Think about it!

theadequatemother

I love Aristotelian logic…elephants are big. Mountains are big. Elephants and mountains must be the same. Surgeons try to solve problems with surgery. OBs are surgeons. Therefor OBs must solve all problems with surgery.

Really?

My OB practices the way you suggest they should as do most of his colleagues. There is nothing they like as much as an uncomplicated vag birth. They also pay more than cs or complicated inductions here believe it or not!

Guestll

Maybe these surgeons push for surgery because it’s the best option. It doesn’t have to be the only option or the last option.

Others will address your fallacies in their replies, so I will simply say that I once believed most of what you have written. And then I stopped listening to propaganda, and started hearing the truth. If you wish to be taken seriously by anyone who has honestly reviewed the available scientific literature, you’d be well advised to do the same.

http://twitter.com/Stepuhhnie Stepuhhnie

And there isn’t such a thing as pro-MD propaganda?

Guestll

I’m sure there is. What does that have to do with scientific facts?
You regurgitate all of the tripe you’ve undoubtedly read on message boards. I did that, too. But a cursory review of history told me that childbirth is inherently risky. So does having an understanding of maternal child health in developing countries, and the terrible outcomes for mothers and babies who lack proper care. We have the luxury of believing that childbirth is safe only when we’re blessed with the saving grace of modern obstetrics.

Rabbit

” But how often do you find that? In Europe and Latin America, sure, you can find that…here?”
Yes, and it wasn’t even all that hard. Three different doctors in three different cities, two different states. Two of those doctors were just the first ones on the list from my insurance company, who delivered at the hospital I wanted, who were taking new patients.
I was induced with all three, twice because I was a week plus overdue (had early dating ultrasounds will all, and those dates lined up with the dates from charting as well), and estimate or not, the increased risk of stillbirth was not worth waiting around for my body to get with the program. The other time was right on my due date, at my request. I am the one who raised the possibility of inducing with my doctor, not the other way around.
Even though I was induced all three times, my movement was not restricted. I was continuosly monitored, but the monitors did not require that I stay in bed. My nurse with the second birth ordered me breakfast when she found out I had not eaten before coming to the hospital. My doctor with the third encouraged me to eat or drink.
These doctors are not mythical unicorns one finds only after a long and difficult search. In my experience, and the experiences shared by my friends, this is pretty typical.

AllieFoyle

Sorry, you’re not anywhere near the end of the story. In fact, you’re missing most of the relevant information. Episiotomy rates are low, the increased c-section rate corresponds with better outcomes and isn’t as high as you think, and pitocin is a useful medication with legitimate indications, not some horror drug designed by OBs to ruin women’s experiences.

I think there are small elements of truth in some of what you say. Women are indoctrinated to believe that there is something desirable and superior about natural birth and brainwashed to fear hospital “interventions” and that does sometimes lead them to avoid OBs. Reading comments like yours (and there are many that trot out the same spiel about episiotomies and too many c-sections, etc) makes me feel that there is a serious disconnect between what women are being led to believe and what actually is the case when it comes to childbirth. My local hospitals have started advertising their birthing centers, and all the ads focus on facilitating women’s choices and offering things like CNMs and doulas and tubs and homey environs and pain meds for those who want them. It seems to me that your criticisms might have made sense years ago, but now hospitals are eager to accommodate women’s wishes, just within the bounds of safety.

What good does it do to go around and say things like “OBs are surgeons” or to squawk about pitocin and c-sections without giving the full story? Interventions are not the devil. Things like c-sections and inductions are done for a reason–to mitigate risk. Whipping up undue frenzy about them is counterproductive. Many women and babies are healthy when they would not otherwise be precisely because of these interventions. In fact, many women prefer c-sections, epidurals, and inductions to letting nature take its course, because they know that its course is frequently nasty. I remember being horrified at the very idea of episiotomy. My perspective changed after actually having children. I know I’m in the minority, but if I were forced to have another VB I’d absolutely prefer an episiotomy to an uncontrolled tear. Different strokes for different folks. Hospitals can and do accommodate women who have different preferences, within the bounds of safety. HB midwives can only accommodate women who want one type of experience. When things veer off course, they lack the resources and knowledge to right the ship.

Captain Obvious

OB/GYNs are primary care practitioners, helping with healthcare from puberty until death in women. Helping with puberty, menstruation, birth control, std prevention, gardasil vaccines, preconception, pregnancy, infertility, management of thyroid, diabetes, PCOS, and incontinence, osteoporosis, low libido, pelvic organ prolapse phyical therapy, breast lump detection and management, menopause, cancer prevention and cancer management, ppd anxiety, PMS, and depression. And OB/GYN can perform surgery if necessary to accomplish these goals. OB/GYN are not just surgeons, end of story. Homebirth midwives are birth junkies, end of story. Homebirth midwives do not accomplish anything near what OB/GYNs can accomplish for a woman’s entire life span of needs!!!

JustADoc

Have you ever manually removed a placenta? You act like it’s a common procedure, which makes me think you don’t know what you’re talking about. It basically involves sticking your hand and arm up through the vagina and into the uterus and peeling away the placenta. Yup, docs are SO eager to do that! However, if you have a retained placenta, you’d damned well better be hoping for a doctor who can remove it, cause that’ll ki you.

OK, you found a single bad case. Do you have statistics to back up that this is an endemic problem? If you don’t then all you have is a straw man that no-one will argue against, as no-one here is going to defend bad medicine.

To put this into context, over time, Dr Amy has presented several different lines of hard evidence that the death rate for babies is higher in home birth than it is at hospitals, in America. This specific blog post is about one such instance.

Captain Obvious

This was a second year resident. Residents are basically apprentice doctors in training. Retained placentas and manual extractions are common enough. Retained bits of placentas after term births and retained products of conception after miscarriages or D&C happen. I find fault that a pelvic ultrasound wasn’t done to detect the retained bit of placenta. To me that is common sense, but then again I have been doing this for 21 years. A D&C could have been done and all is well. I bet this resident will never forget how to work this up on future patients. This is more then can be said about Homebirth midwives. They have no accountability, no sense of learning from their mistakes, no malpractice insurance to compensate victims.

BeatlesFan

Oh for crying out loud. The whole “unncessary interventions” thing makes my head explode. Just because an intervention isn’t a blood transfusion or an emergency c-section, it doesn’t render it “unnecessary.” With both my children, I had heplocks and a managed third stage; there was no way to know the heplocks weren’t “necessary” until AFTER all was said and done and I wasn’t bleeding to death. How the hell was anyone supposed to know BEFOREHAND if they would be necessary or not? Same goes for the managed 3rd stage- perhaps, without a shot of pitocin, I would have still delivered the placentas just fine, no problem, good thing I didn’t get that evil pitocin! Or, just as likely, I could have hemmoraged instead.

Do you have insurance on your car? If you do, why? You’re giving companies money and yet, if you don’t get into an accident, the insurance is unnecessary! Why wear your seat belt? You only need it if you’re in an accident, otherwise it isn’t necessary! Do you have smoke detectors in your home? You do? But WHY?! They aren’t necessary unless your house is on fire! Oh, you mean you have insurance and smoke detectors and wear your seat belt IN CASE something bad happens? You’re right, that’s totally different than heplocks, monitoring, pitocin, or c-sections! Oh, wait…

Where are all the natural birth junkies buying their magical crystal balls, which enable them to know, beyond a shadow of a doubt, which interventions will be necessary or not? I keep looking for one, but Wal-Mart always seems to be out of them.

http://twitter.com/Stepuhhnie Stepuhhnie

Insurance on a car doesn’t do you any harm. Your point is completely irrelevant.

Eddie

Insurance on a car costs me money that I could otherwise put to other uses. Are you going to suggest that the medical interventions done during childbirth typically or commonly or usually cause harm?

Guestll

Just wondering, which interventions are you okay with? Husband/partner present in the delivery room? Birthing ball, labouring in water? Perineal massage? Aromatherapy? TENS machine? Counter-pressure on the lower back? Heating pad? Sterile water injections? Support of the baby’s head during crowning?
Which of these interventions do you approve of, and why? Be specific, please, as to which interventions you endorse.

Bombshellrisa

The birthing tub IS an intervention, the midwives I apprenticed with called it “the midwife’s epidural”.

BeatlesFan

I didn’t realize my heplocks and pitocin did me any harm, either.

Rabbit

Sure it does, unless you’ve found an insurance company who will provide coverage for free? Insurance has a cost, literally. We’ve just decided that the predictable, consistent cost is a better bet than the risk of going without.

Alenushka

Of course it does. $200 a month I could have spent on amber beads and sage.

Bombshellrisa

Exactly. Smaller interventions don’t get the credit that they deserve. I guess people have watched too many episodes of Grey’s Anatomy and think that everything has to be a dramatic mess for an intervention to be necessary.

She said on the Fed Up page that it was causing problems with her webhost and/or server.

theNormalDistribution

Amy, I don’t like how you vilify Bailey for having been arrested for prostitution as if it has something to do with the issues of homebirth midwifery. Firstly, whether or not she is a prostitute has no bearing on her guilt or innocence in the homebirth death she attended or whether or not other midwives should choose to support her. Secondly, not everyone would agree, regardless of legality, that there is anything immoral or unethical about prostitution, so it doesn’t necessarily speak to her character, either.

JenniferG

I’m not anti-sex worker in theory, but I am anti professionals engaging in illegal activities. I think it is relevant because it shows a disregard for rules and the law, and rules and the law are IMO important when it comes to health care providers.

Playing Possum

I agree. It’s not the actual crime so much as the fact that a crime was committed. Sure, there are laws I think are dumb, but I’m still going to obey them, because it’s a worthwhile societal contract. Like vaccinating, not littering, saying please and thankyou.

theNormalDistribution

How about a woman who obtains an abortion in a place where it is illegal? Would she be no longer fit to practice in health care?

What a woman does with her body on her own time is irrelevant unless you can demonstrate some direct risk for harm in her professional life. ‘She did something illegal therefore she disregards rules therefore she is an unfit health care professional’ is not a sound argument. I’m pretty sure my doctor jaywalks and occasionally speeds, but that doesn’t make him unfit to practice medicine.

http://www.facebook.com/lizzie.dee.71 Lizzie Dee

What a woman does with her body on her own time is irrelevant..

Maybe. One does not normal enquire about the sexual habits of those who provide services.

Don’t see any parallel at all between abortion and prostitution – except that both can provoke strong reactions in some. Again, it is not the morality or legality of prostitution – and knowing more facts in this particular case might change perceptions. But at the moment, one could suspect that both midwifery and prostitution were seen as easy ways of making money without much need for training or education, as opposed to an ideological commitment to transgressing conventional boundaries.

ratiomom

I do believe that it is relevant because it underlines her total lack of professionalism.
People who are employed as sex workers are overwhelmingly those who live on the fringes of society, have mental health issues or substance abuse problems. There has been a lot of debate about whether the ‘happy hooker’ really exists. I think we can all agree that the vast majority of sex workers have chosen that line of employment because of other problems in their lives.
Even without those issues, she is still engaging in behaviour that is illegal in her state. Can’t you agree that someone who is in the habit of breaking the law in the sexual sphere has no business working with vulnerable patients and children in their homes?

Squillo

Exactly. Her arrest for prostitution may not say anything about her morals, but it does suggest a certain lack of judgement that I’d find troubling in anyone whose judgement might be the difference between life and death for my baby. I’d feel the same way about a pilot arrested for running illegal slots.

theNormalDistribution

“Can’t you agree that someone who is in the habit of breaking the law in the sexual sphere has no business working with vulnerable patients and children in their homes?”

Are you kidding me? No, no I certainly can not. I can not agree that anyone has any business telling an adult what she may and may not do with other consenting adults and her own body on her own time. And I fail to see how whether or not she accepts money for sex has anything to do with the choices she makes as a homebirth midwife.

ratiomom

So you believe that the problems I mentioned (mental health and/or substance abuse problems, life on society’s fringes) are not a factor in most sex workers’ choice of profession?

Do you know a lot of healthy, happy, financially stable women who prostitute as a hobby next to their health care careers?

Personally I think the ‘happy hooker’ is a myth. The motivation to become a sex worker always involves either financial hardship, some type of addiction or a mental health problem. I agree that what consenting adults do with their bodies is not the government’s business, but a person with the problems mentioned above is clearly unfit to work in patient care.

theNormalDistribution

I think that making a judgement about a person based a generalization of what type of person you think would make the same decision, rather than real ramifications of the action itself, is irrational and discriminatory. That’s all you’re doing. Generalizing about all women who choose to have sex for money, and then ascribing characteristics to a single person based on her choice. You can conjecture about the existence of a “happy hooker” until you’re blue in the face. Your inability to conceive of a person who does not fit your stereotyping of prostitutes does not make it fact.

The Bofa on the Sofa

I am, in fact, very pro-legalization of prostitution. However, that comes with it the regulation needed to maintain its safety, including the safety of those participating.

Selling sex over Craig’s list (as has been suggested) or by some other illicit manner is NOT the same as safe and legal prostitution.

thankfulmom

OT: Has anyone heard of this before? I read that a woman’s midwife told her to use tea tree oil and garlic cloves internally for a week before the GBS test… presumably to get a negative test.

I’ve heard of women trying to use garlic to cure GBS, but never to get a negative test in the first place. That’s right up there with the idea that eating a certain way will help to pass the gtt test, I see a lot of that too. Personally I wanted to know if either of those test indicated I needed treatment…as in antibiotics and insulin.

Guest

Tea tree oil will burn the cr*p out of sensitive vaginal tissue. egads.

Gene

Tea tree oil is a go to remedy for a lot of things “crunchy”. It’s big in the cloth diapering community. I hadn’t heard specifically about its use in treating GBS (show me the RCT or I call BS), but it doesn’t surprise me at all. Garlic vaginal suppository as a treatment has been around for years and has been debunked.

Certified Hamster Midwife

It’s great for athlete’s foot, but I wouldn’t put it full-strength on my lady parts. Owwwww.

Gene

And Lysol was originally an all purpose wonder chemical that was good for cleaning your floors and your vagina (general douche and birth control). Double ouch!

AllieFoyle

I think tea tree oil is also a hormone disrupter, so even less desirable for a pregnant person to use it in such a way.

Victoria

Not the tea tree but garlic yes. See Wren’s story on Hurt by Homebirth.

Certified Hamster Midwife

To get a negative test it would either have to kill enough bacteria or interfere with the culture somehow. I thought it didn’t even have enough of an effect to do that.

here we have a case a a medically trained doctor who tore the head off a premature baby and pushed it back in to perform a cesection.
Will he go to jail???

I understand that if a states requires licensure then the citizens must abide but a life sentence… these parents consented to their HB. NOONE FORCED THEM.

Bombshellrisa

It’s not being erased, it’s the way disqus sorts comments. Make sure you are choosing “Newest” view from the choices of “best” “oldest” or “newest”.

bela

Dr. Amy if you want to help birthing mothers and babies you must stop trying to dictate how and where and women must birth. As a medical doctor you should start promoting and assisting in creating training programs outside of what is obstetrics to help midwives reach the standards that you consider adequate. Midwifery will not stop, please understand this, it will go forward and even nurse midwives have a direct entree program that does not require nursing. So if you have a BSN in literature and then go on to study CNM for 3 years that makes you more prepared to assist in natural physiological births?

Bombshellrisa

Nobody is dictating anything. Dr Amy has no problem with certified Nurse Midwives and highly trained midwives in areas where homebirth is a part of the healthcare system (complete with standards and protocols that risk women out of home birth and include back up MDs and hospital transfer plans). The problem with homebirth in most cases in the US is that the midwives who are willing to attend it are not trained properly, have no back up physician or clear transfer plan and are not honest about the risks of using them as care providers or birth attendants (home or at a birth center).
People don’t get BSNs in literature. BSN stands for Bachelor’s of Science in Nursing. The title Certified Nurse Midwife implies that in addition to studying nursing, a course of study in midwifery was completed. A midwife with a degree in something else who does direct entry into midwifery is called a licensed midwife.

bela

you are absolutely correct.. BA in literature..

She should stop bashing midwifes.. no one is justifying what that particular midwife did.. my point is that you cannot group people together and say that they are all the same. Not all OB’s are like that doctor.. or should I start a campaign about all obstetricians b/c of what that OB did?? NO that would be illogical.

That that statistics for CPM/DEM are not comparable to hospitals in certain states, well maybe that is true, but instead of degrading people, she should create campaigns that are useful for progress.To some people she sounds like a fascist, unruly medical doctor who believes that everything she says is the only way to see things. People automatically are turned off by her. She is only creating wars and certain people will not listen to her. They will think, ohhh here we go another MD trying to put down HB or midwives.

I am from Puerto Rico and I am a midwife and our statistics are excellent. I studied to be a DEM, I have a BSN am an EMT and finishing my CNM. I studied at a birthing center in Tx. and at the local university here in PR. Both studies were extremely important in my formation as a midwife. But what I can truly say is that my studies for DEM was more intense, focused on hands on management, complications, referral etc..

PR has a 47% c-sec rate, highest in the industrialized world for LBW, and premature labors. The OB’s are mostly men, women cannot get up during labor, 90% episiotomy, some hospitals don’t even allow the partners in the room until mother is pushing…? Is this acceptable for Dr. Amy, should I be considered a felon because I assist women in having a respectful and safe experience? (our statistics have a marked difference with the OB’s). Intelligent people as Dr. Amy is not using her brain power or strategic approach if she wants to see improvement of perinatal outcomes… Changes occur through non violent communication, strategies and unification. If this war continues it will not help mothers and babies…

LibrarianSarah

Actually a lot of people are justifying what that midwife did and are raising money for her defense. That was kind of the whole point of the post.

bela

I think the whole point of raising money is because it should not be tried as a homicide or manslaughter. These parents agreed to HB. NOONE forced them. Let the courts decide that she have to pay for her malpractice.. not a lifetime sentence… seems illogical…

Why did the family even stay…? Since when have midwives become dictators of birth? Part of birthing at home is also self educate… read, read, read!!!

How many doctors out here? My husband is a malpractice lawyer and how many times have we seen that when everything is perfect you are a hero, but if something goes wrong… , lies are started, perceptions are changed, lawyers are involved, anger dominates…

Before the court of public opinion decides who is guilty of what this case should be seen in court as many other cases are.

Making it a murder trial is very discriminatory.

Hopefully it gets seen in supreme court of justice because even if she was neglectful this kind of neglect should not be grouped in with rapists or bloody murderers, etc..

Ah here we go with the victim blaming. Maybe they thought that this “expert in normal birth” was, you know, an expert and when she said that everything was OK they believed her. You market yourselves as “experts” and expect people to give you money for your services but as soon as anything goes wrong you blame them for listening to you? I’ve seen teenagers who are better at taking responsibility for their actions then you people. Special needs teenagers at that.

Guestll

But Dr. Webb isn’t a dictator! Why did the family even stay, if they really wanted a section? Part of birthing in the hospital is also self educate… read, read, read!!111!!!

Guestll

Also, kindly explain how “making this a murder trial is very discriminatory.” Please feel free to cite actual legal references, particularly as they relate to the law as written in the state of North Carolina.

suchende

>Part of birthing at home is also self educate… read, read, read!!!

Read what, exactly? Most of what you can read on HB is total garbage.

“I think the whole point of raising money is because it should not be tried as a homicide or manslaughter.”

The legislature of NC thought differently when they defined EXACTLY what this midwife did as murder. Maybe you should let the hubs handle the legal analysis.

suchende

“Before the court of public opinion decides who is guilty of what this case should be seen in court as many other cases are.”

That’s hilarious, when you keep referring to that decapitation case and the news coverage that was strictly BASED ON THE PLEADINGS! What was the outcome of that case, dear? What expert testimony was presented? What was the outcome? Or are you just gonna keep pounding what discovery was done in the Court of Public Opinion?

E-m

She was practicing illegally and in the course of doing so also caused the baby to die. NC defines that as murder. There is nothing discriminatory about holding her accountable for it.

bela

she should be tried as practicing without a license..

but hey.. all of you have your perception, I have mine.. I will not change you, you all will not change me. I hope that someday communication & dialogue (not one sided) become the forefront of political and social issues.

Guestll

Any perception on the recently released Oregon death rates?
I come here precisely because the dialogue is not one-sided. Try being the voice of dissent on a pro-NCB blog, and see how long your comments stay up. This isn’t an echo chamber. Stick around and find out for yourself.

suchende

Why should the prosecutors not enforce a law the elected legislature passed?

Squillo

Licensing provides benefits in two ways: it allows the consumer to assume a basic set of criteria for education has been met and provides some recourse should the practitioner commit malpractice. On the provider side, it shields you (except under very limited circumstances) from prosecution for murder and other charges in the performance of your normal duties.

Any practitioner who deliberately places him- or herself outside of those protections should not expect to exercise them. If the DA has reason to believe Bailey’s negligence cause the baby’s death, the correct charge is murder or negligent homicide.

suchende

So true: you can’t cry malpractice when you’re not practicing anything.

Bombshellrisa

What is it you are trying NOT to change? This sounds like a flounce, rather than a comment made by someone who has reviewed the facts. As someone who has stated that one should continue to learn, perhaps you might benefit from reading the studies and articles cited here and then see if you continue to support the CPM/DEM model of care.

Sullivan ThePoop

Especially considering that giving birth unassisted seems to be safer than using a CPM/DEM.

Eddie

but hey.. all of you have your perception, I have mine.. I will not change you, you all will not change me.

Then why are we (group “we,” not you and I specifically) communicating at all? I am a scientist. “Perceptions” are mostly irrelevant. Reproducible data is relevant. I am absolutely open to changing any and all of my opinions — when the facts prove me wrong. Are you?

And here is the crux of the difference in opinion: You are talking about perceptions. We are talking facts. Some of these facts are anecdotal. (Such as the article here) Anecdotal facts don’t prove anything whatsoever in isolation, but can help raise awareness and can be useful in that sense. Some of these facts are hard scientific data. See many of Dr Amy’s other blog posts for those. We trade in facts. You keep referring to perceptions. Do you see the distinction I am making?

Cellist

Really, really well said.

http://www.facebook.com/lizzie.dee.71 Lizzie Dee

But don’t murder charges always fail because you can’t murder a non-person? And the arguments for not giving rights to the unborn are unfortunately fairly convincing.

You need either some way of prosecuting these women for negligence, practising medicine without a licence (with penalties that actually work, not piddling fines and no oversight when they go on operating) or a change in the law that can give limited rights to an about to be born infant without leaving that open to abuse of the mother’s rights.

Nobody forced them, but did the midwife present herself as someone skilled and able to handle complications? Did they understand the risk of choosing someone who used the title midwife? Heathcare professionals are required to discuss the risks and benefits of treatment, as well as refer patients to other care providers if they are not qualified to deliver the level of care needed.

thepixiechick

It is not discriminatory to charge her with murder. Supporters of this ‘midwife’ are saying ‘if a baby died under the care of an OB would he be charged with murder?’ but that analogy doesn’t hold water. Because OBs are educated, trained, qualified, regulated, licensed, and insured. There are many avenues through which a negligent or dangerous Ob may be held accountable (Dr Biter is a prime example). A better analogy would be –
What if a person with NO medical qualifications, training or licence (except maybe the odd first aid certificate), had previously been arrested and charged with practicing medicine without a licence. And what if that person, after being ordered to cease and desist, practiced medicine without a licence AGAIN, and someone died as a result, would that person be charged with murder? I am pretty sure the answer would be a resounding “Hell yes!”

Eddie

Sorry, but in my book, raising over $10,000 for bail for someone you haven’t met counts as justifying what that person has done, or at least counts as saying “it’s not so bad.”

suchende

>She is only creating wars and certain people will not listen to her. They will think, ohhh here we go another MD trying to put down HB or midwives.

Those people are stupid. If the data says a choice is unsafe, it shouldn’t matter how that message is delivered.

Eddie

Those people are stupid. If the data says a choice is unsafe, it shouldn’t matter how that message is delivered.

I mostly agree with you, with one proviso. To oversimplify, when an entire scientific community speaks dismissively and insultingly about an entire non-scientific community (e.g., IPCC vs deniers, MDs vs homebirth, MDs vs anti-vax, …) science loses in the court of public opinion. Ultimately, we’re better off if some in the community can bite their tongue, not rise to baiting, and calmly, and with excessive politeness, debate the crazies. This will have no effect on the illogical, but will have an effect in the court of public opinion … which itself sometimes has a very real effect on outcomes.

I’m not saying any specific person should do this. I’m talking big picture here. *Don’t* read this to say that I think Dr Amy should write or argue any specific way, as that is not what I’m saying!

Within science, we are trained to ignore how a message is delivered. Outside science, that training is absent, and the difference shows.

suchende

I totally agree with you, on every point.

Victoria

I like what you have said Eddie but I think you don’t have to be “within science” to be able to look past delivery to message. I think that is just about maturity.

Eddie

You’re completely correct. I oversimplified to make my point, which is not entirely fair. People trained in the hard sciences (I can’t speak to any others) are specifically trained to pay attention to the facts and ignore the presentation. (We’re human, so no-one is perfect at this.) But as you say, plenty of non-scientists are capable of the same.

It’s more than just maturity, but maturity helps a GREAT deal!

Victoria

I think we are getting to the lament of a lack of critical thinking skills being cultivated regardless of discipline. Everyone ‘should’ be taught to think about what they are hearing/reading/watching and move beyond the initial reaction and ask questions about all aspects. If this did happen the NCB movement’s staunch defenders would not only think about Dr Amy’s message beyond the emotional words but ask themselves why she gets emotional. Then they could understand what this blog is about without having to be told countless times.

bela

I tend to think that communication & dialogue tend to be indicators for positive change and a grand majority of people do not respond to people who prey or get off on bad press and slander.

A childish response is to start to publicize all of the malpractice suits that OB’s have against them… which having a husband in the field i know of ALOT that are based of real bad medicine. But I do not think that is the mature route. …

suchende

Fine. That has nothing to do with the validity of her arguments. This is the rebuttal of those who know they’re wrong: fine, HB isn’t very safe, but say it *nice!* Come on.

Guestll

Dr. Amy is meeeen. We get it. But she isn’t wrong. If you’re going to tone troll, be advised, we’ve heard it all before.

Eddie

Actually, if you think that a certain area of medicine is doing things in a directly harmful way, then publicizing the malpractice lawsuits of doctors in that area of medicine would be an effective way of raising attention. It’s only childish if you do it to say, “So there!”

No-one here that I have seen is saying all MDs are good, nor that medical science is perfect. However. There is a very clear way to stop bad MDs from practicing medicine in the United States. There is no effective method whatsoever to get bad midwives out of practice.

Bombshellrisa

Exactly-Dr Amy has been forthright about both Dr Biter and Dr Fishbein

Bombshellrisa

See your comment above “here we have a case a a medically trained doctor who tore the head off a premature baby and pushed it back in to perform a cesection.Will he go to jail???”

Sullivan ThePoop

I think you should have stuck with that because it was a lot more mature than what you brought to the table later.

Bombshellrisa

AGAIN…she isn’t bashing midwives in general. She has worked with CNMs. She is calling attention to the fact that homebirth midwives who call themselves CPMs are not honest about the risk involved using them as care providers due to their poor or nonexistent training.
I understand that Dr Amy’s tone may not be one that you respond to right off the bat, but please don’t assume that everyone feels the way that you do. There are plenty of people who comment here who have had homebirths or are doctors and midwives. There are also people who post here who have considered homebirth before learning more about it here.

Squillo

you cannot group people together and say that they are all the same

No, but it is possible to make some basic judgements on the minimum acceptable standards for a profession. And the argument here is that, in a developed country, the standards for CPMs are inadequate. They don’t meet the global standards the WHO is trying to establish for international professional midwifery–standards the WHO hopes to move even low-resource countries toward.

AllieFoyle

If you want to argue that PR has outdated, paternalistic obstetrical practices, go ahead. If they don’t let partners into the room and women really can’t move or choose not to have an episiotomy, then sure, fight to change that. You won’t get much argument about that here.

The solution to those problems, however, does not and should not require that women place their faith in poorly trained midwives who practice in resource-poor settings that endanger their clients and their babies.

Sarah

Bela I think you are missing the point. The point is there are people with inadequate qualifications passing themselves off as medical professionals who are greatly increasing the risk of an otherwise healthy baby dying at home birth. That is the point. Whether you’re a midwife, a doctor, or a freaking garbage truck driver, doesn’t matter. What should matter is stopping those people claiming to be ‘educated’ and putting babies and mothers at risk.

bela

RE: The title Certified Nurse Midwife implies that in addition to studying nursing, a course of study in midwifery was completed. A midwife with a degree in something else who does direct entry into midwifery is called a licensed midwife.

Licensed Midwife- Licensed by the state according to state standards

Certified midwife- graduate of ACNM program, non nurse midwifery but went to a nurse midwifery direct entry Program (3-5yrs)

CNM- Certified Nurse Midwife, (BSN first 3-5yrs)

CPM- Certified professional Midwife (direct entry to midwifery,m with or without BA, usually takes 3-5 years)

DEM- studied midwifery different routes of study has not been certified as a CPM through NARM 3-5 or more)

Traditional/Granny Midwife- learned from mother, grandmother or someone in the community. LIFETIME

Bombshellrisa

And?

you know why a CPM take 3-5 years to complete? Because that is how long it takes to be present at the required number of births. Since most homebirth midwives feel comfortable with having 3-4 clients due a month. But attending a few births a month is not the same as attending 3-4 births a week or a day. Which is what doctors and cnms do all the time. First day of clinical rotation in nursing for me was an eye opener. 12 babies born during one shift-it had taken me six months of being an apprentice to one of the busiest CPM practices in the state for me to see that.

Optimistic-Guest

CPM do not even need GED and until last, no CPR training.

bela

wrong… you people have to educate yourselves a bit more..

Bombshellrisa

No, you posted above the qualifications for CPMs. There is nothing about a GED there. There isn’t even a uniform set of qualifications for someone to be called a CPM in the United States, as some states do not recognize the CPM credential. In Oregon, for example, you can feel moved to “catch babies” and call yourself a midwife and charge clients to attend them during birth. Melissa Cheyney who is the chair of the Oregon Board of Direct Entry midwives does not feel that licensure is important for midwives. No formal training. No license. No malpractice insurance. No accountability.

Captain Obvious

Not to mention having a license, medical malpractice coverage, back up OB and hospital, and a college/organization to hold them accountable for their outcomes. Doctors and CNM follow these guidelines. CPM and DEM do not. CPM and DEM don’t even risk out breech, twins, AMA, post dates, previous CS, or FTM.

Amy Tuteur, MD

” As a medical doctor you should start promoting and assisting in
creating training programs outside of what is obstetrics to help
midwives reach the standards that you consider adequate.”

One of the things that never ceases to amaze me about homebirth advocates like yourself is that you appear to have absolutely no idea that homebirth midwives are a second, inferior class of midwife that would not be eligible for licensing in any other first world country.

High midwifery standards already exist in this country. Certified nurse midwives meet those standards. Anyone who isn’t a certified nurse midwife has no business calling herself a midwife. No one should license these self-proclaimed “midwives” who have no idea what they are doing and no concern about who dies as a result.

bela

Tuteur, please look outside your bubble of the united states and see all the humanitarian work that all midwives do around the world. Do you not respect Robin Lim a CPM who has helped so many mothers and babies and won a CNN award. Is she not a midwife in your eyes? CNM, CPM, CM (certified midwives), DEM, have helped many women around the world because very few doctors do that kind of work. Like I said I have studied both routes of entry in midwifery and although each distinct in there own ways studying midwifery before nursing I was educated extensively in the field of OHH births and birth center births. I went on to study nursing, EMT and nurse midwifery to keep expanding my knowledge, because a good midwife never stops learning as should any doctor.

One of the things that never ceases to amaze me about anti-homebirth advocates like yourself is that you appear to have absolutely no idea what homebirth is about, what midwives have studied, and people like you keep thinking in inferior classes whether it be in midwifery, race, or economic status..

Hey I am Puerto Rican… I must be way inferior to you because I am not white and believe in midwifery whether it be DEM, CPM, CNM.

My mother is in Spain and as a nurse I cannot work in Spain and you Tutuer cannot work as an OB without taking the necessary exams… my husband who is a lawyer graduated from Yale cannot work in Spain….

For your own health Dr. Amy please find strategies that are helpful to our society. Look for solutions, bashing and slander have never been appropriate mechanisms of change.

Amy Tuteur, MD

So you’re suggesting that CPMs are better than nothing? If you’re referring to the 3rd world that might be the case or it might not. However, we are not discussing the 3rd world, we are discussing the US where there is no need to decide between a grossly undereducated, grossly undertrained attendant or nothing at all.

Squillo

I just did a story on a program in which masters midwifery students went to a developing country to exchange knowledge. The U.S master’s students were glad to learn about the use of local herbs and how to deliver a baby in the dark with no source of light. Great, important skills for an undeveloped area, but no one would suggest that such knowledge is especially useful in the developed world.

Know what the traditional midwives were desperate for? Lessons in the safe use of oxytocin (which the U.S. contingent brought with them) and neonatal resuscitation.

Karen in SC

Guest post, maybe? I’d like to read that.

Squillo

No can do. It’s for a mag I write for, and they own it. The thrust of the story was about fundraising for the project, so it’s probably less interesting than you think, but I can send a link if you email me: squillomb @ gmail. com.

Bombshellrisa

Well, based on the data about planned homebirth with a CPM that came out of Oregon, we know that suggestion to be wrong!

Bystander

Seriously? An actual, qualified midwife… actually, scratch that — there’s lots of midwives: an actual, qualified OB, is even more beneficial in impoverished nations than these ‘better than nothing’ pairs of hands. If you say you can help, you’d better be able to help with the often complex cases you’ll see.
Poor women don’t sue, and newspapers don’t report. So because they can claim to be ‘helping’, the eye-watering death toll that accompanies their efforts is excusable as ‘hopeless anyway’ while the successes many of which would have been just fine anyway are claimed as saving lives.

All women deserve better than unqualified help. It is positively parasitic, and more than a little racist, to think that a CPM is in any way good enough for the Third World. She’s not even good enough for the First World despite having healthier clients, better access to sanitation, medicine and back-up for her mess-ups.

Guestll

You know Robin Lim works in Indonesia, right? You know that there’s a world of difference between Indonesia and a developed nation?

I have enormous respect for the midwives I’ve met who work in SSA. That doesn’t mean I’d let any one of them deliver my own baby, and it doesn’t negate the fact that the CPM credential is a sham.

Bombshellrisa

Robin Lim is a CNM
Why do you believe it’s about thinking someone/something is inferior? CPMs ARE inferior care providers and it has nothing to do with their race or income level or the races and income levels of their clients. I am a non white, former doula/midwifery student who studied ONLY OOH birth. Which taught me….. what it looks like for someone to give birth in their living room or a room at the CPM run birth center. In fact, a great deal of the clients of these CPMs are upper middle class white women (who else has $3600 just laying around to fund an “experience”, with pregnancy/birth photography, doula services and herbs costing extra?)
Since Dr Amy doesn’t object to homebirth when it’s within a system where there are skilled caregivers, back up physicians, transfer plans and protocols that risk women out of giving birth at home, she most certainly IS looking outside “the bubble of the US”.
I have no idea what you mean about mechanisms of change, when clearly the only change that needs to happen is for the CPM credential to be abolished. Certified Nurse Midwives fill the need for clients who prefer the midwifery model of care.

bela

Robin is a CPM.. loom at her.website please. Sorry to say that the CPM credential will not be going away anytime soon.

Bombshellrisa

I stand corrected.
You are right, the CPM credential isn’t going away anytime soon. Meanwhile more women and babies will be harmed or killed at the hands of these women.

suchende

I am more optimistic. I think it can be eliminated, must be eliminated and will be eliminated. And MANA being forced to reveal their death rates will contribute to it. As the benefits of HB have entered the mainstream consciousness, so will the risks.

Sullivan ThePoop

Wow, all that studying and you still act like a 12-year-old. What a sad world.

Bombshellrisa

Reading again through your qualifications, why in the world aren’t you livid that CPMs practice? We always wonder why CNMs stand together with their subpar CPM/DEM counterparts. Why? Why, if you have complete so much study and training, can assess risks and care so much about the care women get in hospitals, WHY WHY WHY would you stand up for midwives who refuse to be trained and refuse to use advances in medicine and technology to help their patients? I noticed you mentioned “natural physiological births” and by that I suppose you mean spontaneous vaginal deliveries. Being educated and highly trained means that you are able to help the large percentage of women who will not have these (or develop complications with their pregnancies). A taxi driver, sales clerk or barista could assist at a “natural physiological birth”-hardly something that requires training.

http://www.facebook.com/beth.henson.54 Beth Henson

FYI, a BSN is a Bachelor of Science in Nursing. It is a four year university degree that prepares you to sit for the NCLEXRN to obtain a license as a registered nurse. I know of no CNM programs that do not require the person to be a RN. Some schools only require an associate degree, but they also require the person to take several bachelor level nursing courses before starting the actual master degree level coursework that will then allow them to take the CNM certification exam. (All degrees referenced are US based).

Bombshellrisa

Bela claims to be an RN who was a direct entry midwife and EMT and who has now completed her CNM. You would think that she would know what those letters mean : )

http://www.facebook.com/beth.henson.54 Beth Henson

I suppose none of those are impossible. I have a friend who was a paramedic for years before returning to school to get a bachelor degree in business so that she could become a supervisor. Later she got her associate degree and RN and is currently considering returning to school to become a CNM. But she will still need the BSN level nursing classes and the master level CNM classes to practice, which will take 3 years full time.

Bombshellrisa

I know it’s possible, I just have a hard time believing someone whose comments read like drunk texting has completed such an extensive education.

http://www.facebook.com/beth.henson.54 Beth Henson

Well I did say it wasn’t impossible, not that it was probable, lol.

MikoT

Agreed. Also the awkward unfamiliar phrases like “medical doctor”, “outside of what is obstetrics”, “natural physiological births” strongly suggest a lack of real world usage.

Dr Kitty

I have friends who were nurses before they became doctors.

They would be the first to tell you that no amount of experience as a nurse will prepare you for being a doctor, the skillset and responsibilities are different.

Same with nursing and midwifery or midwifery and OB. It just isn’t the same.

http://www.facebook.com/beth.henson.54 Beth Henson

Oh, I agree. Ive been an RN for 15 years and worked in OB for over a decade and i would never presume to equate my experience with an OB’s skill level. I can, and have, delivered a baby in a pinch, but certainly don’t consider myself knowledgeable or skilled enough to be an actual midwife. I was just pointing out that some people bounce around between different healthcare roles before finding their niche.

Eddie

So is your point that since there are bad doctors, it’s OK to have bad midwives as well? Or do you actually expect someone here to defect the doctor from that news story? Negligence and incompetence are bad, no matter who is providing medical care. One bad event does not excuse another.

Optimistic-Guest

No one is going to defense that doctor or fundraise for him’

Bombshellrisa

Remember the midwife in Oregon who has people on Facebook asking questions that could help her defense and people have created a cookbook to sell to raise funds for her defense. Yeah.

And what pops up in today’s NYT? this story about a doc who allegedly made some spectacularly negligent decisions and is being prosecuted for manslaughter. (N.B.: License has already been stripped.)

Amy Tuteur, MD

Moreover, anyone claiming to be a doctor without being licensed to practice medicine will be prosecuted. There is no double standard.

AllieFoyle

Horrible story, but did you notice the problem was that a c-section was not performed? In what universe is this legitimately horrifying story any support for the idea that having poorly trained midwives is a good idea? The doctors actions certainly sound disturbingly negligent in that document, but a low-intervention HB midwife wouldn’t have fared very well in that situation either. If anything, it suggests that doctors ought not to be pressured to lower c-section rates or to blindly favor VB.

Squillo

If he was unlicensed, he should be tried for murder or manslaughter (depending on the jurisdiction’s definitions.) If he was licensed, he will, at the very least, face an investigation by the hospital and the state medical board, and very likely, a malpractice suit. Even if he is licensed, it is possible (although less likely) that he could face a criminal charge. None of those remedies–save the last–is available to the state in the case of Rowan Bailey.

Your implication is that, because Ms. Bailey is a midwife, she should enjoy the protections from prosecution other medical professionals enjoy. But she doesn’t accept the same responsibilities other professionals do. Why should the state grant her special status?

JenniferG

That is horrific. All negligent providers should be held accountable, whether in hospital or in homebirth. That is the point. I don’t know why people like you continue this defense — “there are bad doctors too!” “babies die in hospital too!” Yes, they do, and that is why people need to stop supporting bad medicine.

In this case I noted that all this was to avoid a c-section. There goes natural childbirth advocacy’s work again.

Captain Obvious

In retrospect, Dr Webb probably wished he had made some different decisions like just going ahead with the cesarean delivery. But why would he or anyone believe a 28 weeker in preterm labor not be able to deliver vaginally? Since Bela feels perception has so much more to do with the situation than fact, then suppose this…A baby that is preterm should just slide out. Just for perspective, at 28-29 weeks the abdominal circumference at 50%ile is 230-240 mm , and at the 95%ile it is 253-264mm . Now at 40 weeks the AC in the 5%ile is 305mm, at the 50%ile is 340mm, and at the 95%ile it is 375mm. Can a baby at 28 weeks have a belly huge enough that it is bigger than the smallest AC at 40 weeks? Dr Webb didn’t think so. Or Dr Webb may have felt this baby’s abnormally large abdomin was related to a fatal congenital anomaly like bilaterally enlarged polycystic kidneys which can be lethal, and he didn’t want to perform an unnecessary cesarean on this likely FTM for a baby that wouldn’t otherwise survive. This woman would have a CS, with no child and be subjected to RCS or risks from a TOLAC. He may not have felt comfortable transferring the woman risking her to deliver en route to the other hospital. EMPTALA or COBRA laws may have prevented him from “dumping” her onto other hospitals. Then when delivery was occurring, the horrific realization that the 28 week AC was going to produce an abdominal dystocia without correction from shoulder dystocia maneuvers and the added horrific incident or the skull subluxing from the spine he went into recovery mode and wanted to minimize any further shock by just going ahead with the CS. I am sure this sentinel event will have a root cause analysis and M&M conference to help prevent this from happening again. Dr Webb and the hospital’s malpractice insurance will probably settle out of court. I wonder what the autopsy will find in the infant? Was it a lethal anomaly? Why did she go into preterm labor at 28 weeks? Was it because of the anomaly? Could she have been spared a CS? I will not expect Homebirth midwives to go through such organized processes, but rather blame the patient and keep on delivering other babies at home as long as they can without regulation.

Haelmoon

I think this is a very well articulated response. I have previously commented on this specific case when it has been discussed previously. I have been involved in a case with severe abdominal dystocia (not prenatally diagnosed, the significant fetal ascites in this case) and it is a traumatic event for all involved. This baby also had a cephalic replacement (Zavenelli’s maneuver) followed by a c-section, after which the baby still died – due to the anomalies.

I agree with the thought that maybe this baby could deliver vaginally. Even if it was not a lethal anomaly, combined with a preterm delivery, some anomalies do become essentially lethal. There are advantages to avoiding a c-section with a poor prognosis fetus.

I have also been involved in a case with fetal decapitation – mind you, it was already a stillbirth due to fetal hydrops at 29 weeks. It was also traumatic for the family involved, but that does not necessarily mean that a c-section would have been better. It is always traumatic when a baby dies.

However, I absolutely doubt that a poorly trained home birth midwife would have in any of the above situations, made any sort of positive contribution. Just because OBs are involved in a bad outcome, the situation must be examined. A term intrapartum stillbirth is significantly different than a difficult delivery of a complicated, possibly non-viable pregnancy. Furthermore, this obstetrical case will be examined in detail, both through M&M rounds, quality assurance round and the court of law. These midwifes do not have ANY REVIEW at all of their bad outcomes, and therefore, they will not learn from their losses.

If you are involved in enough deliveries, you will have a bad outcome. However, professionals will learn from these situations, CPM’s throw up their hands and say too bad, some babies weren’t meant to live.

Who do you want looking after you when something go wrong???

The Bofa on the Sofa

Thank you to CO and Haelmoon for some absolutely spectacular insightful comments.

Yes he will probably go to jail. He will also probably lose his license and have the crap sued out of him. Unfortunately, homebirth midwifes don’t more often then not don’t lose their licenses (if they have them in the first place) because their licensing board consists of other homebirth midwifes who rally around their “sister in chains” and most lawyers won’t bother suing them because they lack malpractice insurance.

And even when they DO lose their licenses, they continue to practice anyway, aren’t penalised when even MORE babies are lost to their negligence and are supported by the HB community at large.

suchende

Should we start making a list of OBs and midwives who should have been jailed but weren’t? Are you imagining that MDs aren’t sometimes jailed for malpractice?

Bombshellrisa

We have a partial list going on the Sisters in Chains page anyway…may as well put it to good use

Amy Tuteur, MD

Are you suggesting that a homebirth midwife could have handled that situation? Don’t you think it’s a bit ironic that you are criticizing a doctor because he should have performed a C-section and never suggested a vaginal delivery to the patient?

bela

never would suggest that, just seems that her bad medicine decapitated an unborn baby.. should she convicted of murder?

LukesCook

If the doctor’s actions fit the legal description, then yes, of course. Why do you think he refused the cesarean though? Perhaps because of all the screeching about cesarean rates being too high? I see you’ve beaten that drum here yourself.

anonymous

I notice that you’re pointing to a site that just talks about a civil lawsuit. Where’s the criminal case? Why didn’t the parents call the police about this? What about one of the other people that was in the room? Seems odd to wait so long to go after the doctor here.

Rachel

Are you sure it’s two deaths? I am seeing in the news articles you posted, that this lost happened in July. And that she was charged in Feb. Nothing about two deaths.

Lost in Suburbia

Dr. Amy – according to the SECOND link you posted, they have now corrected it to reflect that there was just one still birth, in July 2012, as I had suspected. Take a look at the link, and please correct your title and content. No need to provide more fuel for the “Dramy” hate.

Amy Tuteur, MD

Thanks. I corrected the post.

Anon

Can anyone link me to a report or article about the prostitution arrest? The link from this blog doesn’t seem to show it.

Lost in Suburbia

It’s in the link, under the Jackson Co section, Feb 9. find the one that starts with Tashana Star Ward. It’s the 3rd sentence.

E-m

I didn’t see this post on Sunday. After the title, I spent half my concentration while reading looking for an April Fools punch line. I wish it were a joke.

” This death was not her fault, nor was it the mother’s. Meconium
aspiration has a low survivability rate even in hospital, and there’s
not really a good way to tell until fetal heart tone disappears.
Chorioamnionitis and Funisitis are generally not noted UNLESS a baby
dies in delivery, and are basically “well, this was wrong anyway”
diagnoses. Properly noted, those two issues can show up in about 40% of
births with no complications. It’s like saying Bob had a heart
problem, when it was stepping in front of a city bus that killed him. ”

Funisitis does not show up “with no complications”. Did she even read the definition?

This link puts the incidence of chorioamniotis at 2-4% of term deliveries.

(The incidence can be much higher for premature labors and PROM. The PROM factor is expected.)

Chorio is indeed “a complication” and a treatable complication – and a detectable and preventable complication.

This delightful example of humanity appears to think chorio and funisitis are more variations of normal.

http://www.facebook.com/profile.php?id=100002171364303 Anj Fabian

dang – dropped the link for chorio. I’ll let you all look up the incidence and if my stated numbers are off, feel free to correct me.

The Bofa on the Sofa

Meconium aspiration has a low survivability rate even in hospital,

????

I don’t know much about OB, but that seems to be …. um… fairly and completely bullshit. But I could be wrong.

Gene

I’m trying to think of a baby I’ve known that actually died from meconium aspiration… Out of all of the babies born with meconium whose care I’ve been involved in, I don’t think I can remember a single one who died.

The Bofa on the Sofa

Well hey, let’s not get a little reality intrude on midwife apologetics…

Eddie

I think one thing we see — with people defending Rowan Bailey and the Sisters in Chains and their ilk — is people who self-identify as a persecuted group and who are prone to belief in conspiracy theories. The world is out to get them, and only they see the truth. This explains why they circle the wagons to defect ANYbody in their group. “It’s us against the world. The charges were trumped up.” and so on.

Some people get a great feeilng of power out of feeling persecuted. Look at how important they are, that these vast conspiratorial forces are out to get them.

An Actual Attorney

“Some people get a great feeilng of power out of feeling persecuted. Look at how important they are, that these vast conspiratorial forces are out to get them.”

Eddie — that’s it You’ve just clarified so much for me.

Sue

Spot on, Eddie!

Mrs. W

So sad. If only every dime that was raised for the midwife could be matched for the grieving family to better enable them to prosecute.

Elizabeth

Prosecutions are conducted by the state and do not depend on the victim’s resources. This is almost enough to make me investigate whether public prosecutors’ offices take donations, though, and if so send one to Jackson County NC.

CanDoc

Meh, I don’t feel strongly about sex work in principle, whether it is legal or not, although I am disturbed that it is so often synonymous with the exploitation of women.
BUT professional organizations ALL require members to meet a minimum code of conduct and can refuse to license/include for unprofessional conduct. Which to me is the issue. So if fake midwifery licensing/professional bodies want to start setting themselves up as “Professionals” in order to garner insurance reimbursement… THEN, I’m pretty sure prostitution as a side-business to homebirth should be frowned upon. Especially in places where it is illegal.

CNM

Does anyone have the link to the blog with the parents side of the story? I know it is floating around out there but I can’t find it. Obviously there are many many issues here, but me the creepiest issue is that she presented herself as a licensed midwife. I just don’t get it.

The Bofa on the Sofa

Of course she was a licensed midwife! She just doesn’t mention who granted her the license.

“Murder is the intentional loss of life; acting in order to destroy life.”

I beg to differ. That is one form of murder. They deliberately ignore the other forms of murder, the kind that apply to this kind of case. And I love the slippery slope argument:

“If we allow our freedoms in birth to be taken away, what freedom is next?”

I guess we also lose the right to represent ourselves as other kinds of medical providers as well. And pilots. And lawyers. And, well, anything else that requires actual expertise, unless we provably have it.

CanDoc

I would be interested in a lawyer’s take on this.
Although this whole situation sends me into an emotional rage, I wonder if “manslaughter” or “negligent homicide” would be more accurate charges?

suchende

Here’s what I believe is the relevant code, from the NC General Statutes:

§ 14-23.2. Murder of an unborn child; penalty.

(a) A person who unlawfully causes the death of an unborn child is guilty of the separate offense of murder of an unborn child if the person does any one of the following:

(1) Willfully and maliciously commits an act with the intent to cause the death of the unborn child.

(2) Causes the death of the unborn child in perpetration or attempted perpetration of any of the criminal offenses set forth under G.S. 14-17.

(3) Commits an act causing the death of the unborn child that is inherently dangerous to human life and is done so recklessly and wantonly that it reflects disregard of life.

_______________

(3) seems to cover it quite handily.

Eddie

Thanks for posting this. I did later see the above, but didn’t have time to post until now. I absolutely agree … #3 fits perfectly.

Seriously, I’ve read news stories about the doctors who go to Africa to help women who’ve been permantly damaged by deliveries taking four days or more. Anal fissures and other terrible injuries. And, of course, babies born stillborn, dying during delivery. And then I see American women seeing mult-day “natural” deliveries as something to be triumphant over? Why don’t we just do this: American women who want to have a home delivery can go, with their midwife, to Africa to deliver. They can trade places with a woman from Africa who would be delighted to have access to modern health care, and the greater chance of survival and fetal survival that it represents.

Only in the first world do we eschew something as critical as immediate access to medical care for childbirth.

Some of these people need to see the reality of home birth for those people in the world who don’t have any other choice.

A tangent, sorry, but yes, #3 above.

A question for the doctors here — as a layperson in this area, it strikes me that a four-day delivery would be quite likely to result in fetal death, no matter where you are in the world. Am I wrong?

Dr Kitty

No Eddie, you aren’t wrong.
A contraction cuts off blood supply to the baby.
Contractions last about a minute, and happen every 2-5 minutes.

You try holding your breath for a minute every 2-5 minutes for 4 days…

Lost in Suburbia

I’m no doc, or midwife, or other healthcare worker. Yes, I would imagine if there were 4 days of contractions every 2-3 minutes at a minute long, it would be bad for baby. But I suspect that most people who claim a “4 day labor” aren’t contracting like that for four days. Regular non-medical moms talk about labor starting and we mean that contractions are happening with some frequency. For example, my “4 day labor” really only had contractions every 2-3 minutes during the last few hours of labor. Before that they were in the every 10 minutes or more, lasting less than 45 seconds, and totally manageable. So, while a mom’s description of her labor is accurate – she was laboring – it may not mean the same thing as when a medical professional is talking about ‘active’ labor, or what other people think when they hear about someone laboring – which often is the last part of labor.

Bombshellrisa

You would be surprised how long some midwives allow labor to continue.

Stacy21629

A lady in my church labored with CPMs at a birth center for 5 days…ROM for 2…pushed for something like 3 hours against an incomplete cervix before finally transferring to the hospital….where the doctor also then diagnosed and corrected the fact that baby’s head was positioned abnormally. Of course, she went on to birth the 10# baby vaginally, without an epidural or pitocin – though she suffered severe perineal morbidity…and then went back to the SAME BIRTH CENTER AND CPMs for her second child. Seriously?!?!?! She joked about asking the midwives the second time around about making sure they didn’t overlook the baby’s-head-in-the-wrong-position thing again. Gah! Thank GOD her second child was only 8.5# and born after only 6 hours of labor. I was so terrified for her and that baby. People are so blind it astounds me.

Bombshellrisa

I have a friend who experienced something a bit like that-she was 41w6d and labored for 36 hours with 6 hours of pushing before a hospital transfer was initiated. She is currently pregnant with her second child and again has engaged the services of the same midwives. She says this time she is going to birth at the birth center as opposed to trying to birth at home, because she believes birthing in a tub will help things along better.

Guest

This depresses me.

http://www.facebook.com/lizzie.dee.71 Lizzie Dee

But if birth is ever so ever so natural, and Real Women Do It Well, why would you be in labour for days? Wouldn’t that in itself indicate their might be a problem of some sort? (Proper labour, I mean.) Wasn’t the Friedman Curve based on poor outcomes from long labours? So it is just one more gamble on top of a gamble to “prove” something or other that satisfies a woman’s ego. Risk does not apply to meee! I am Supermom!

Renee Martin

I never thought of it this way, how horrifying. No wonder babies start to go into distress after hours of pushing, especially after a long transition. NCBers blame it on interventions, but its gotta be the baby wearing out. At some point, they won’t recover.

I wish every single HB mom would read this, so they would realize that laboring and pushing that long is a bad idea.

Renee Martin

I have suggested the western NCBer /undeveloped world woman trade for some time. If only we could make it happen!

Siri

Fistulas, not fissures. Even worse – much worse.

Eddie

Thanks for the correction. Clearly, I am not a doctor. I’ll edit my post above to be correct.

Siri

Not a doctor, but a jolly decent contributor to these comments..

Renee Martin

I still think this is pushing it, and that she was charged as such to make an example, and to get a plea.

Although I would love to see her jailed for murder.

suchende

After reading the parent’s account, I think it fits like a glove.

thepixiechick

I think that reckless indifference to human life can constitute the mens rea for murder.

MaineJen

I think the kind that HB midwives are involved in would be categorized as “negligent homicide?” Not actively plotting to kill someone, but instead allowing them to die through incompetence or unwillingness to intervene, or both? Not a lawyer, but it makes sense to me. OTOH, an actual doctor has a moral imperative to intervene when they see someone in medical trouble. So yeah…I’ll take the doctor. Thanks.

http://www.facebook.com/profile.php?id=613905265 Bambi Chapman

The detective here labeled my daughter’s death a Negligent Homicide, but “Wouldn’t go on a witch hunt to prosecute her”. That was totally awesome!

MaineJen

OMG, I am so sorry

suchende

Among other definitions, the NC code defines murder as:

“Commits an act causing the death of the unborn child that is inherently dangerous to human life and is done so recklessly and wantonly that it reflects disregard of life.”

So you don’t have to have the intend to kill the unborn child, your mental state merely needs to be “reckless and wonton” with regard to the danger to human life.

suchende

Know what? I am thrilled NCBers want to buy her a strong legal defense. Let them hire the best criminal defense lawyer money can buy, please, by all means. I don’t want anyone crying “poor defenseless midwife” should she be convicted.

Elle

But maybe after they raise some money for a poor family that just lost their baby?

Renee Martin

They won’t do that, they don’t raise money for the families.

Penguin0302

Jennifer Margulis indignantly claimed the past few days that her primary concern is the safety of mother and baby.

By all means Ms. Magulis, as many posts in answer to your blog cheered you on, please proceed.

Lost in Suburbia

Aside from the link you posted, all references I’m finding in online news sources only mention the July 2012 death. Any links to other sources to back up the claim of two deaths?

Not My Normal Nym

I can’t post links, but if you search for Amy’s blog post titled Third 2012 Homebirth Death in North Carolina (dated August 7, 2012), you’ll see the story. If you look in the comments, Amy links to the mother’s blog post on Bailey.

Lost in Suburbia

I looked there, but only found references to Avery’s death in July 2012, nothing about a death in February 2013.

Box of Salt

The first link is the article about the July death. The link including the word SECOND goes to a news article mentioning the Feb 7th stillbirth (both are dated March 28, 2013,but are two different news outlets (Blue Ridge vs Citizen Times)

Lost in Suburbia

I have a suspicion that the second death is not really a second death, but a misreporting of the first death. I found other articles that said the July 2012 death was reported to the medical board this February, investigated, and then she was arrested. All the articles that specifically relate the charges with a time when the death occurred refer to the July death. I just can find nothing to corroborate a Feb 7th death, and everything except that one link keeps talking about the July death. I would think the media would be all over this if they thought there were two deaths from this one person. I’m just trying to be sure that we’re not so gung-ho about getting the truth out about Avery’s death that we’re making up something that didn’t happen.

Box of Salt

I agree. But why does Blue Ridge have a specific date (Feb 7) and describe the death as still born at a home address? In the July death, the baby was delivered after transfer to a hospital.

Renee Martin

One death is bad enough.

Lost in Suburbia

I agree. Doesn’t mean we should accuse her of something that might not be true.

Dr Kitty

Look, if you want to claim it is just “a few bad apples” bringing HB midwifery into disrepute, you need to mentally complete the adage.

Rowan Bailey’s case is evidence that the whole barrel is getting spoiled.

Squillo

Exactly. The next time someone argues the “bad apple” angle, I’m going to suggest they visit the “Sisters in Chains” site and get back to me with what they think it would take for homebirth advocates to stop supporting a midwife.

Renee Martin

8k?
8k?
and counting?
disgusting.

melindasue22

Nearly $ 13,000 raised now. Ugh. I will never understand why they will blindly support a cause like this without the facts.

http://www.facebook.com/profile.php?id=100002171364303 Anj Fabian

They don’t need facts, because they have faith!

Amy Tuteur, MD

Because the facts are irrelevant.

It does not not matter what happened to the baby or whether the midwife committed malpractice. All that matters to homebirth midwives and their supporters is their ability to entertain themselves by attending births and charging for it. Short of taking out a gun and shooting a patient point blank, homebirth midwives want to do whatever they want without regard to who is harmed.

melindasue22

So sad. And then Gloria Lemay was all “oh I am so proud of the birthing community for coming together yada yada.” Their main reason for supporting Rowan is because they are blindly supporting the preservation of midwifery without regards to what actually happened. People are not infallible. Just because someone knew her in high school does not make her a good midwife.

Guest

I continue to be puzzled by the vehement defense of these obviously incompetent and/or negligent midwives. If I were a homebirth advocate, I would want to make sure these midwives were prosecuted and kicked out of our ranks. They give home birth midwifery a very bad name. Why defend them? I see the talk of “the burning times” and so on…not at all analogous to the current situation. Some of my FB friends are on that twitter list – I intend on unfriending them. I have some pretty extreme birth friends…I just don’t get the support and even deification of these midwives.

GiddyUpGo123

It’s because the incompetence is shared by everyone who is a CPM. If you were a *competent* midwife, you’d be really pissed off that incompetent women were parading around calling themselves midwives and killing babies in the process, because it really would give you a bad name. But if you’re incompetent just like they are, damned right you’ll defend them because you know there’s a very good chance that one day you’ll be in the same position as they are in, and you’d want others to defend you, too.

And it’s not like CNM’s are out in force against them, either. I know, I know, the first response will be from a CNM who will try to defend themselves, but I don’t care if “there are some who are unhappy about it and trying to do something.” The bullshit from the CPMs is far, far too accepted in the ranks of the CNMs, right up to the administration of the ACNM, who, instead of kicking the snot out of them, is way too focused on playing nice. CPMs have no business sharing the stage with CNMs, and the failure of the ACNM and it’s members to completely shun them just gives them the air of legitimacy they crave.

They are uneducated hacks that are running around claiming that your CNM is a waste of time and resources, which is merely a luxury (they can’t afford it, so they won’t bother; the converse is, you only bothered because you could afford it).

If you think your time and effort to get your CNM is worth it, and that it is critical to making you a competent midwife, then you must consider the CPM to be unacceptable. So do something about it.

Laural

I’m in complete agreement. I became a nurse with the ambition of eventually becoming a CNM, but, I am faced with the fact that I do not fit into the ‘culture’ of midwives and their ‘we’re all together in this’ attitude; I’d be shunned from within my profession and also viewed from without I’d be a ‘midwife’ in America in the same category (in most people’s eyes) as any other homebirthing midwife. Meh. I think I’ll spend my grad school dollars and hours in pursuit of something else. Or wait until the CNM’s WAKE UP already…

manabanana

CNMs outnumber CPMs and “other” midwives probably 10-1 and their patients outnumber the home birth midwives’ 10-1. Many CNMs have no clue about home birth midwives. Yes, some leaders at the ACNM pay lip service to CPMs, in my experience most CNMs don’t know about what’s going on in the local home birth community. Truely – there is very little interaction between CNMs and CPMs. I don’t think they’re playing nice. They’re just unconcerned and unaware. They’re too busy working.

The Bofa on the Sofa

CNMs are “unconcerned” that nearly 10% of the people calling themselves “midwives” are incompetent, uneducated posers?

Wow, I never realized that the problems with CNMs is THAT serious.

Stacy21629

“CNMs are “unconcerned” that nearly 10% of the people calling themselves “midwives” are incompetent, uneducated posers?”

Yea, pretty much. I am currently 19 weeks pregnant with my second child (first born at home with a CNM) and while I am planning to have this one at home as well I am insistent on being cared for by a CNM and being <5 miles from a hospital with 24 hour staffing (i.e. not a community hospital that has to call in an anesthesiologist). While my CNM requires all the standard testing – I've had an initial blood screening including typing, immunities, etc, my ultrasound is next week, we'll do glucose testing and GBS on schedule and I insisted on a heplock during labor – she works with all the local CPMs and had one deliver her own baby in December. If we were to move outside of her area for any future babies she has told me I should just have a CPM attend me in the future. No.Freaking.Way. I am fully aware that in a crap-hits-the-fan type of scenario, I am not in the best place…but there's more back story than I can share here about our decision regarding being at home – it's NOT all about the 'experience' – for me anyway…but I recognize it and I'm taking as many precautions as I can – CNM, testing, ultrasound, IV, etc. But NO WAY would I have an uneducated person attending me instead.

But it does bother me that my CNM works so closely with the CPMs. But then, my last homebirth CNM did too – both were the only homebirth CNM in the state/area respectively, so they are a resource for the CPMs without having to go to an MD "in the system" for stuff.

The Bofa on the Sofa

both were the only homebirth CNM in the state/area respectively, so they are a resource for the CPMs without having to go to an MD “in the system” for stuff.

Yep, they accommodate and encourage incompetence.

This is why I, unlike a lot of people around here, do not have much respect for CNMs as a profession, either. They are absolutely part of the problem.

Guest

I couldn’t agree more. I have said in other posts here that the CNMs that do homebirth or support homebirth are, in my experience, just as bad as any CPM or DEM. They subscribe to the same belief system/philosophy. It was a CNM who recommended to me NOT to get GBS testing and to attempt to cheat on my GD test. It is a CNM friend who constantly posts anti-C-section screeds on her FB page, along with anti-vax nonsense and anti-ultasound articles. It was another CNM friend who badmouthed my OB practice, even though they are supportive of NCB and all in all wonderful – she also criticized on of my practice’s CNM’s as a “medwife” har har. They are just as much of a problem as any lay midwife, if not worse, because women actually trust them more, thinking their credentials and training mean something. In my experience, if a CNM does homebirth, she is just as into non-evidence based medicine as any Gloria LeMay.

Eddie

I find it amazing that anyone with actual medical training would recommend against GBS testing and suggest cheating on a GD test. (My wife had GD, fortunately controlled with dietary changes as she was borderline GD, just barely met the diagnostic criteria. We watched her blood sugar carefully to be sure.)

What justification would someone have for counseling against these tests, for counseling for falsification? My mind boggles.

The Bofa on the Sofa

What justification would someone have for counseling against these tests, for counseling for falsification?

Seriously?

It because when these complications are discovered, they are handled by “interventions.” However, if you don’t know about it, then you can avoid the interventions.

I’m not making this up. They will avoid testing for risky conditions because they don’t want to go throught what will have to be done if they are found.

In order to sell this, however, you have to deny that they are risky in the first place.

(BTW, shoving garlic up your hoo-ha is apparently NOT an “unacceptable intervention”)

Eddie

I hear what you’re saying, and it makes sense, but I just have so much difficulty wrapping my brain around that kind of thinking. I guess I should understand this. Someone I knew in high school, her mom discovered a lump in her breast and waited two years to get it looked at because she was afraid of what she would find. By the time she finally got it looked at, it was too late to do anything (although they tried). But to imagine that someone would play that game with others’ lives… I know it happens every day, all over the world, but I just cannot comprehend it.

And why would garlic be bad? It’s natural! Then again, GD is pretty natural as well. As are bacteria. And death. Cyanide and botulism are natural. Some places in the US have very high naturally-occuring levels of asbestos in the soil.

Victoria

I know you are not making it up. Why are NCB sites writing about the ‘risks of ultrasound’? Because ultrasounds can risk you out of homebirth and can lead to interventions. That these interventions are to save the baby and or the mother doesn’t matter – natural is better. In Canada where we have university educated midwives that have a list of things they are supposed to risk out for, I know a few who will still have homebirths for patients who have had no ultrasounds, no GD tests, no GBS tests (though that is rarer these days). Not having an ultrasound is not on the official risking out list – though many of the situations/conditions that can be discovered through ultrasound are . . .

Victoria

This sounds like the midwife for my first child. It is a major reason why I cannot recommend midwifery care to pregnant women that ask me. If they want to go that route I suggest some questions to test out how much of an idealogue the midwife is. Of course, that is predicated on that midwife answering honestly. The midwife I had lied to me about GBS, lied to my doctor (in my charts) and was rude and dismissive to the nurses on Mother and Babe (“they don’t know how to care for babies more than three days old! I do!). I fired her. In darker moments I wish I had punched her in the face too.

Renee Martin

I think your post is right on, and touches something really important- ideology. If a HCP is heavy into the woo, it doesn’t really matter how well they were trained, because they won’t use it anyway. What good is it to know about GBS and GD if you just tell moms to refuse the tests?

A CNM that has drank the kool-aid is among the most dangerous, because she is most trusted by the average mom- Magnus Snyders death due to breech is a good example. There are a few excellent CPM/LEMs that do work with/refer to CNms and even OBs, but this is the exception not the rule. If a CNM promotes LDEMs, I would be very wary. She either thinks her training is unimportant, or thinks their is just as good, yikes.

Even MDs can fall into the woo to the point they become a menace. It seems to me that most of the MDs that got into woo because of their incompetence and professional problems, not that the woo caused those problems.

Renee Martin

I guess it depends where you live.
The CNMs here know, but few dare to say anything. Some are thoroughly disgusted with the CPM/LDEM nonsense, but are afraid to speak up.

http://www.facebook.com/NavelgazingMidwife Barbara Herrera

I *am* really pissed and I am a CPM. I am disgusted at the rallying around this horrible “midwife.” Please remember there *are* a few of us who see things for what they are: a murderous wretch.

Box of Salt

Barb,
Please keep speaking up!

manabanana

Thanks, Barb. For the reminder that all CPMs are not incompetent boobs. There are plenty of CPMs who would like to see the profession professionalize. In my experience, most of them leave after they participate in the dysfunction for a little while. I agree the CPM profession is not professional – but not that all CPMs are incompetent. That’s just not true.

Some of us were deceived by choosing to become professional midwives. Not only do mothers believe the rhetoric, but midwives and aspiring midwives believe it too. The slow reveal of the reality of “professional midwifery” comes over time. Like I said, this is why good CPMs are leaving. I wish the leadership at MANA, NACPM, ETC would take notice.

KarenJJ

I remember reading an account of a chiropracter student who had become disillusioned with the profession he was training in. I really felt for him.

AmyP

I was listening to the Dave Ramsey show (it’s a personal finance call-in radio show). A woman called in whose husband was a new chiropractor with $270k in school debt and a $25k a year income from his practice. He was also having ethical problems with some of the people in his profession, and so wasn’t able to pick up hours in other practices.

Ethically, that’s a really tough one.

I keep hearing that chiropractor school is really expensive ($200k seems standard). It’s pretty nuts to have to spend that much and then not be a real MD at the end of it.

The Bofa on the Sofa

Somewhere, in some internet forum, someone asked the question as to why it seemed that all chiropractors come off as slick salesmen and seem to be really good at marketing?

My answer was that chiropractors that aren’t don’t make it as chiropractors and are currently working in other fields.

Siri

Good for you, Barb! Your website has some amazing stuff on it, and I admire your courage.

Susan

It’s disturbing too that her case is being used as a reason that NC should have licensed CPMs. They already have CNMs they don’t need to license a less educated midwife. They do have legislation pending that makes it easier for CNMs to practice without being directly tied to an MD. I don’t neccesarily like that but at least there would be a minimum standard for a homebirth care provider that has some teeth. ( and I bit my fingers not typing something about the term birth workers sounding like sex workers but now I suppose now it seems not such a stretch)

AlexisRT

Disturbing, and willfully stupid. As far as I can tell, this woman is not even a CPM (I can’t even verify that she has anything I would call training–links to somewhere offering “quantum midwifery” do not qualify!), so a CPM licensure law would leave her illegal anyway.

Natalie

CNMs can practice independently of physicians in Oregon. It obviously hasn’t helped the homebirth death rates.

Renee Martin

It does help. CNMs have much better numbers than the LDEM/MWs here.
They can still be deadly though.

An Actual Attorney

Two questions: (1) Did you notice that if you donate $15 you get a free distance-reiki treatment? Who could turn down that? (2) Does indegogo TOS allow you to raise funds for bail?

Certified Hamster Midwife

Indiegogo seems to be where people whose projects aren’t approved by Kickstarter go.

I’m reading the TOS. It doesn’t seem to prohibit it, but these things are prohibited:

Rowan is innocent until proven guilty. The mother’s account will be
presented in court UNDER OATH. People tend to tell a very different tale
when put under oath with a penalty for perjury. Then, she will be
strenuously cross-examined. Every word of what she wrote will be
questioned. That’s why it’s not a good idea to shoot your mouth off in
blogs, FB, twitter, etc. Haven’t we watched enough of these debacles?
The mother has probably been (well) advised to remove her post. Of
course, the curious in the birth world have found a cached version and
resurrected it and distributed it everywhere. Very immature, very
damaging and, in the end, could really cause some pain to the grieving
mother that no one intended. We all need to get a grip here and stop
sending that link around. Please feel free to post this.”

Guest

Glorie LeMay sickens me. That is all.

Karen in SC

classic victim blaming.

Amy Tuteur, MD

So let’s see if I get this straight:

Rowan Bailey is innocent until proven guilty, but the mother of the dead baby is a liar until proven otherwise?

What happened to respecting the feelings of grieving loss mothers? Oh, right, that’s only for the women who don’t hold the midwife responsible for the baby’s preventable death.

Lost in Suburbia

What happened to the respect of the process of law? I don’t think that just because we can respect the fundamental right of the accused – presumption of innocence – that we are automatically saying the mother is a liar. I think respecting Avery’s mother and father is ensuring that due process is followed, and when that results in a guilty verdict, we can hope that justice is served. I am too cautious of cases where people have been railroaded and thrown in jail for years, only to be found innocent at a retrial, to get all tied up in damning someone before we have even heard the evidence presented to the jury.

auntbea

We think she is accusing the parents of lying because she wrote this: “The mother’s account will be presented in court UNDER OATH. People tend to tell a very different tale when put under oath with a penalty for perjury”

Lisa the Raptor

Has anyone reached out to this mother from our group? i wish someone would. I would but I’ve done it twice now and it kills me for weeks after. I’m just a wuss.

http://www.facebook.com/profile.php?id=613905265 Bambi Chapman

Lisa, that has been done

Squillo

Or maybe, like Lemay, Bailey will be acquitted because a stillborn baby isn’t a person under the law.

I thought I read more detail on the law in other stories from the same paper, but I can’t find the right link right now.

http://www.facebook.com/profile.php?id=613905265 Bambi Chapman

Lemay has been posting many grotesque things.

“Lawbreakers who got a lot of support from people who could see the importance of taking a stand when laws are unjust: Ghandi, Martin Luther King, Nelson Mandala, and Jesus” (which should fire up EVERY SINGLE CHRISTIAN, esp birth workers).

“Yes, alternative birth workers know we can be in deep trouble, yes, we accept full responsibility and the consequences of our actions, yes, it’s nice to have a society that has laws and a structure. However, it’s also right and decent that many people support and lift you up when the going gets rough and the consequences are beyond anything reasonable. We don’t have to read Rowan’s inventory—she can do that herself. The only inventory we need to take here is our own.”

Yet, Lemay and 99% of her followers do not believe Bailey should have any consequences for her actions and absolve her of any responsibility.

Squillo

“Yes, alternative birth workers know we can be in deep trouble, yes, we
accept full responsibility and the consequences of our actions

HA! When has Gloria Lemay ever advocated accepting responsibility for anything? She opposes mandatory licensing, she avoided prison based on the fact that the baby who died due to her hubris and negligence wasn’t a person, and she initially refused to testify at another hearing about yet another dead baby until she was threatened with more jail time.

Captain Obvious

Isn’t this the same “support” that came out of the woodwork for Dr Biter? And months, years later he was found totally innocent and is practicing again. :-/

Renee Martin

He wasn’t found innocent, I am pretty sure he lost all his privileges.

Squillo

He’s done as a doctor in California. He was initially placed on probation that severely limited his practice, then, after a homebirth death that occurred prior to the start of the terms of his probation, a second complaint was filed and he declined to mount a defense. The case is awaiting a final determination by the MBOC, and I wouldn’t be surprised if he either surrenders or is stripped of his license. Last I heard, he was planning to become a CA licensed midwife so he could do homebirths; it would be interesting to see if the Division of Midwifery Licensing (which is under the auspices of the MBOC) granted him license.

Disgusted

Actually Gloria what people, aka birth advocates, tend to do when faced with the prospect of giving evidence under oath -with a penalty for perjury- is take the 5th and refuse to give any evidence at all.
It worked excessively well for Lisa Barrett.
Maybe Rowan could really up the martyrdom ante and claim that her refusal to give evidence is out of a duty to protect her clients confidentiality. Also a Slippery Barrett defence.

auntbea

The only people who should shoot their mouth off are ME!

MLE

She sure is gleeful about the prospect of the mother cracking under cross-examination. She is monstrous. Not only is the mother abandoned by this community, but the head honcho is actually hoping she gets ripped to shreds in court. Tears of rage for her.

Elizabeth

I noticed that too. She seemed to be in the grip of quite a vivid little fantasy about it. Horrible, horrible person.

But if the defense lawyer actually tried that in front of a jury, it would seal Bailey’s fate. Outside of birth junkies’ heads, mothers breaking down is viewed as a negative reflection on those who put them in that state. Although in a twisted way I almost want to see them try it, the better to show what corrupt assholes they are.

Karen in SC

The charge is difficult to find since it’s listed with another. Here it is:

“Tina Louise Bailey, 44, of Craig Circle, was charged with prostitution. A secured bond of $250 was set. Darrell Brooks made the arrest.”

auntbea

What does the prostitution charge have to do with anything? I mean, it’s embarrassing for her. But it doesn’t really have anything to do with midwifery or babyslaughter, unless we are just engaging in character assassination. (Which she pretty much accomplished for herself anyway.)

http://www.facebook.com/jennifer.delaney.90 Jennifer Delaney

morally questionable persons generally cannot be licensed in healthcare professions. That’s why background checks are done on real health care providers, even nurses’ aides. We want to make sure that vulnerable populations (i.e. – those needing personal, bodily care/healthcare) are not at further risk from unethical or morally bankrupt people…. like child molesters or prostitutes or pimps.

Elle

Agreed. Prostitution has never been one of the cleaner “jobs.” By putting herself at risk of disease, she’s putting every child she works with at risk too.

auntbea

Well, in that case, anyone who is promiscuous should be forbidden from health care practice, whether they get paid in exchange or not. Also, anyone whose spouse is promiscuous.

Amazed

Not a bad idea, actually. I once got the attention of a child molester and while he didn’t make it to the end with me, I am far from thinking that I was the only one to attract his notice and I have no way of knowing how far he had gone with others. His wife is a nurse, a very kind lady. I absolutely believe that she should be inspected closely. Fortunately, she doesn’t work in a L&D ward but still.

CanDoc

Actually, health care workers who have certain illnesses have VERY clear guidelines about what they may and may not perform. For example, a Hepatitis B positive health care worker in our jurisdiction may not perform any internal examinations (vaginal/rectal), and absolutely may NOT assist in cesarean delivery, or repair vaginal tears or episiotomies.
Additionally professional bodies always take a position addressing behaviour that is “unbecoming to the profession”, which is grounds for expulsion from the profession. Think Andrew Wakefield in the UK, but would expand to include any activity that would cast aspersions on the profession. This has nothing to do with one’s personal right to engage in sex work. It has to do with the idea of maintaining, literally, “Professional Standards”.

AC

Exactly. I would hardly want my child being delivered by someone who’s at an increased risk for hepatitis, HIV, etc. And, frankly, homebirth midwives aren’t known for their excessive use of gloves, either.

Guest for a day

Simply by working in health care at all, that person is at increased risk for blood-borne illness. Everyone you come in contact with in the hospital is a potential disease walking around, simply because they work there and are constantly being exposed to everyone else’s germs, including HIV/AIDS, hepatitis, and everything in addition to and in between. Home birth midwives aren’t supposed to take those patients and have a smaller patient base from which to pass germs around and typically don’t care for more than one patient at a time.

http://twitter.com/orlikeawhale what’s Tom short for

Well, this is just straight-up hate speech, I don’t know what else to call it when you’re lumping people who have sex for money in with people who *rape children*. What in the actual hell.

anonymous

Well, many of us would prefer not to have people who have sex for money caring for us while we’re naked, etc. We want to make sure that only those who have very clear boundaries about sexual behavior will be involved in the intimate care of vulnerable people. I’m willing to live and let live re. prostitution and try not to go out of my way to judge, but let’s be honest that it involves a situation where someone is placing their intimate sexual behavior outside personal relationships. Not a form of boundary crossing I’m comfortable with in my healthcare provider.

Squillo

I would prefer not to have someone who doesn’t do enough births on a regular basis to make a living and has to get a second job, no matter what it is.

Renee Martin

THIS.
If she needs to prostitute, she doesn’t do enough births, and doesn’t have enough skills. OR, she thinks its worth getting arrested for, which shows really poor judgement.

I don’t have a personal problem with people that sleep around (for free, or pay) working in healthcare. I cannot imagine making MDs and nursing, etc, a profession where long term monogamy, or abstainence, was required.

Not My Normal Nym

This is an excellent point. And as someone who has known and worked with people who were also working in the sex industry, my experience has been they live very messy, unstable lives. Lots of job/relationship turnover, often problems with substance abuse. I have a lot of sympathy for people in that industry since many people who become sex workers have a history of childhood sexual abuse. But that doesn’t mean I would feel comfortable having them as my healthcare provider.

Dr Kitty

As a Dr I don’t actually have to do something illegal to be struck of. My professional body can strike me off for “conduct likely to bring the profession into disrepute”, and the same goes for nurses.

A charge of prostitution would come under that heading.
It isn’t actually so much about the rights or wrongs of prostitution itself. If the public cannot trust that the regulator removes practictioners who act in disreputable ways, the public cannot trust the profession to regulate itself.

Which means you don’t “support” the potential bad apples, you give them a fair hearing, and if they have brought the profession into disrepute you remove them from it.

Natalie

Um. It is likely some of your health care providers are more promiscuous than prostitutes.
And it’s none of your damn business.

fiftyfifty1

Actually it is statistically very UNlikely that some of your healthcare providers are more promiscuous than prostitutes. I know a few doctors and other healthcare workers who are pretty promiscuous. But they can’t hold a candle to an average prostitute.

anonymous

The issue for me is the transgression of the law–it implies a willingness to break other regulations, too. I also agree with the comments above–sex work is typically associated with drug addiction. Yes, there are always the exceptions, etc. It is all of our business just like drug addicts should not be doctors or healthcare workers.

Natalie

Doctors are people. People make mistakes. That’s why we have licensing boards.

We had a lecture last year about drug and alcohol addiction among physicians. A recovered cocaine addict physician told us that 10% of physicians will lose either the life, their license or their families to drug or alcohol addiction.

I guess the good thing about a profession is they maintain standards and try to ensure the people slipping up get help before hurting anyone.

Amanda Stamps

Prostitution should be legal, its only illegal because people want the govt to regulate morality. If it was decriminalized and regulated, it wouldn’t be as dangerous as it is .

Box of Salt

It also shows a general disrespect for the law, and rules and regulations in general. And there’s a surprise!

Natalie

Seriously. If I have to pee in a cup every six months for a drug test and a classmate was dismissed for a DUI, prostitution should not be tolerated.
That’s for professions with ethical standards who value their image and service to their communities though.

auntbea

Wait. Didn’t you just say below that health providers’ sex lives are none of our business?

Natalie

prostitution is about illegal activities- not about a personal sex life.
If it was legal that would be another story- but it isn’t.

Box of Salt

Natalie,
your posts are sending mixed messages. Could you clarify?

Natalie

I apologize for being unclear.
I don’t appreciate when people make comments like “I don’t want a dirty sex worker as a healthcare provider”. I think it’s ignorant and unkind. The point being missed is: if you have any risk of contracting anything from your healthcare provider- they aren’t a professional healthcare provider. If they are they will use gloves, wash their hands, and obviously not put you at any risk of an STI (if you get this close with your provider they will lose their license and possibly do jail time).
I exaggerated saying a healthcare provider can be as/more promiscuous than a prostitute. I was trying to make the point that their promiscuity is their personal life, and if legal, it’s not the business of the licensing boards or patients since the patients shouldn’t be at any risk.
My other point is that of self-regulation. Physicians self-regulate, keeping each other honest and accountable in order to maintain reputability and respect in the community. Example: doctor in LA gets a divorce. He is pissed off that his wife got the nicer car, so he goes tot heir previous home and takes it back. He gets arrested for grand theft auto and loses his license. For taking his ex-wife’s car.
I (along with my classmates) are subjected to regular drug tests. This is for patient safety. My first year a classmate got a DUI, she was expelled from school. Drinking and driving is poor judgement they didn’t want from a future physician.
Prostitution is illegal and generally frowned upon by our society. Most people wouldn’t go to a doctor they knew participated in illegal activity- how would you trust them?
My third point was these are high standards of peer regulation that the profession maintains. Homebirth midwifery is neither professional nor do they have standards, so of course they do not blink an eye to such behavior.
Is that better? Sorry. I’m using the excuse of board studying til my eyeballs fall out.

KumquatWriter

Well said! This is what I meant too, but I didn’t have time to add another comment.

Renee Martin

This is perfectly said. I wish I had been so eloquent!

Amy Tuteur, MD

I only mentioned the prostitution charge because it ought to give homebirth advocates pause as to whether some investigation might be in order before jumping to defend someone simply because she claims she is a “midwife.”

Squillo

Agreed.

Although I have to say that it gave me some hope that it meant she was having trouble making ends meet as a midwife.

auntbea

Well, if you can’t make in *one* vagina-centric profession….

Sue

Sex worker, birth worker – is that what they call “holistic” practice?

The Bofa on the Sofa

Personally, I don’t care about their prostitution activities, although I am curious as to what actually happened to lead to that. You don’t see prostitution charges coming up very often on run-of-the-mill people. Was she a streetwalker or what?

More importantly, though, regardless of what I think of the prostitution charge, I wonder what all her supporters would think of an OB who had been arrested for it? As others have noted, the medical community already self-regulates against it, but what if an OB who had their license taken away for prostitution wanted to work again? Would they support her in doing so?

Of course, the answer is, it depends. As we have seen, they have had no problems even supporting sexual predators as long as that person toes the line of HB.

Would they be so quick to ignore if, for example, Dr Amy had a prostitution charge?

fiftyfifty1

Remember Dr. Amy’s trollop?

kdgd

im guessing thsi was a craigslist sting.

http://breastfeedingwithoutbs.blogspot.com/ Breastfeeding Without BS

I don’t think sex work is morally “bad” in itself (and I support decriminalization). However, I also feel that it would be a little naive to act as though sex work were exactly same as other occupations, like being a police officer, a bank clerk, or a shop assistant. The great majority of women who work in sex work are there by “choice” of some kind, but it’s usually a choice that they’ve arrived at by a variety of personal, social and life-related difficulties–drugs, especially. Sex work inevitably involves one very much with the seedier side of life, from drugs to organized crime to violence, and it’s a very dangerous occupation. If a healthcare worker caring for me had worked as a sex worker, my eyebrows would be raised, put it that way.

Sue

In most jurisdictions, there is a requirement for health care professionals to be “of good character” – which includes obeying the law. Where I work, even traffic violations have to be declared to the licensing authority. Providers who have special access into the lives and trust of vulnerable people rightfully are held to a higher level of ethical behavior than the general population.

kdgd

welli think there are some commonalities in the “professions” even though i think prostitution is moral and HB midwifing isnt. basically both are centered on creating and “experience” for clients, reading and managing emotions adn expectations, manipulation…and both serve the providers desire to work from home and make $$ with few skills or education…

http://www.facebook.com/lizzie.dee.71 Lizzie Dee

It isn’t the morality of prostitution that is at issue for me. It is the romanticising of it. Is it really about creating an experience? Seems to me to come from a similar misguided view of “rights” as the “birth experience”, and maybe just as likely to turn bad.

http://www.facebook.com/MadCatsandBabies Karen Teresa Reekie

I read the birth story on the most recent case, and felt sick. A few people I follow on Twitter have been retweeting the Rowan Bailey thing. Safe to say, I have been doing a bit of unfollowing and blocking today. I have no respect for anyone that could support a case like this, as much as I am pro natural childbirth (where safe and medically possible) I don’t understand why the family of the dead baby are not having money raised for them, not this criminal!!

Lisa the Raptor

Now see prostitution is a bodily rights issue. I think if one were actually interested in human rights they should be trying to get that overturned. But, she’s a murdering prostitute so I have not mercy.

KumquatWriter

THIS (aside from the mockwife bs). Also, promiscuous =/= child molester or disease ridden menace. I find the comments above (or below, wherever disqus puts it) pretty offensive – although I do.agree its a red flag for anyone deciding to start a crusade for her. I bristle at “omg not a HOOKER!” concept.

Not My Normal Nym

You don’t have to vilify sex workers to not have one be your healthcare provider. I’ve known and worked with people who have done sex work and they are not the most emotionally stable individuals nor do they tend to exercise good judgement in general. I truly don’t think sex work is compatible with performing at a high level of competency in a demanding profession where lives are potentially at stake.

Renee Martin

^ I think that it really depends on the person and the exact job. You might be surprised how many escorts, dominatrixes, and strippers have excellent day jobs, husbands and families. I realize that some are damaged, or addicted, but that doesn’t mean they all are.

You only hear of the unstable ones because they cannot, will not, or dont care to, protect themselves and their identities, for whatever reason. These are vulnerable people. You will never hear of the upstanding citizens in sex work because they keep it secret, and strictly segregate these parts of their lives.

There is nothing inherently wrong with sex work, when it is legal, and freely chosen (that people get pushed into it due to poverty-“sex work safety net”- or are enslaved, is horrible, but not part of this conversation.) I would be more concerned over professionals that break laws that can ruin them, because that shows really poor judgement. Its just not worth it to lose a license over prostitution, KWIM?

Not My Normal Nym

I really would be surprised because I have known multiple people in the sex business, including strippers and a dominatrix, and my husband worked as a sys admin for porn sites so he’s met many people who work in the industry in front of and behind the camera. This meme that’s floating around of perfectly stable and normal people who just happen to be in the sex trade just doesn’t jibe with anything I’ve personally seen. It would be like extolling all of the heroin and meth addicts who are married and hold full-time jobs–there may be some out there, but it doesn’t mean that hard drug users in general live healthy, stable lives.

I have no problem with people engaging in sex work or using drugs and I think all vice laws pertaining to consenting adults should be struck down, but (and that’s a big BUT) that doesn’t mean that engaging in these behaviors isn’t unhealthy or self-destructive. A healthcare worker who also works in the sex trade is not someone I think has the judgement to provide good care.

When did being a liberal mean equally sanctioning all life choices?

Box of Salt

Not My Normal Nym: ‘A healthcare worker who also works in the sex trade is not someone I think has the judgement to provide good care.”

Allow to me to add: A healthcare worker who also works in the sex trade WHICH IS SPECIFICALLYY ILLEGAL is not someone I think has the judgement to provide good care.

For the nitpickers, I’ll point out the specific case in question is in NC, not Nevada.

Lisa the Raptor

Of course I am not talking about women who are in the sex work by lack of choice or for drugs or any negative means. I am talking about sex workers who are backed by COYOTE or some other safety net and who work in legal brothels with health codes. AND if those women want to save up their sex work money and send themselves to an accredited midwifery school and then start delivering babies instead I am fine with that too. However the law is the law and she broke the law at least three times. There are sex trades that are legal and states where one can sell full service legally. Go work there.

anonymous

Good luck to them, with all sincerity, but come on. COYOTE and the Reno prostitution houses are not a major recruiting ground for STEM fields.

Renee Martin

Exactly. It is illegal, and as such, doing it puts you at risk of arrest regardless of your personal opinions. I would rather stick to her lawbreaking, and lack of skill, than demonize her preferred work.

Renee Martin

I guess it depends on who you know then. I have known many of both types (normal and responsible, and off the chart junkies). The majority of sex workers I knew were either single moms who wanted more flexibility and time with their kids, or students. Most of these didn’t break any laws, and didnt take their work home, and eventually quit for straight jobs. There were always a few professionals (business, law, nursing- never met a doctor!) in every club, but they stood out because they didn’t socialize.

I never worked in a scummy place, or hung out with street walking prostitutes, but I guess thats kind of the point- all types of places, even upscale places, exist, and the people that work in them are a different demographic (mostly middle class), and they tend to be more “normal”. Not every sex worker (strippers, escorts, doms, porn) is a screwed up, irresponsible person. The jobs tends to attract those types (as they can earn well with no skills and little responsibility) and it tends to create those types (because you are socially sanctioned if others know), but the variation is just so great I can’t see using such a broad brush.

(As for drug addicts, there were as many in the service business as in sex work…..and many do work very hard- their habits depend on constant employment.)

Your last sentence also doesn’t make any sense. Who is “equally sanctioning sex work”? Equal to what? I think people are simply pointing out that you don’t have to be a scumball to have those jobs, not that stripping is = to being a doctor (whatever). What’s being liberal have to do with it?

Lisa the Raptor

Yes^. Aside from total prostitution, I knew many women who have danced and played Dom or done some other work. Most were moms and students but they did always say there were drug issues and to just stay out of that and you could make several thousand a week. If I had the body and didn’t have two left feet I certainly would.

http://profiles.google.com/rainydaylove R T

I worked as a pole dancer and pole dance instructor for years! It’s still my favorite job I’ve ever had! I worked in a famous bikini bar called Jumbo’s Clown Room in Hollywood, CA. I also had a troupe that performed acrobatic pole dancing and aerial displays at parties and other large events! Everyone I worked with was very professional, healthy and athletic. One of the dancers, Alyssa Bell, was working on her PhD in vertebrate palentology at USC and another was working on her PhD in Lingustics and taught sign language. Another was a professional ballerina and yet another left Jumbo’s to travel with Cirque du Soleil. There was nothing unhealthy or self destructive about what we do! It was a job allowing us all to make a great deal of money while pursuing our goals! I think it makes women who couldn’t do the job feel better if they imagine we are all coked out hookers with daddy issues. Your personal experience is limited.

fiftyfifty1

Did you get arrested for your pole dancing ever? Do tell!

http://www.facebook.com/lizzie.dee.71 Lizzie Dee

Your personal experience is limited.

Isn’t everyone’s?

The argument that pole dancing is liberating and feminist is one that I have some difficulty with – can see the point, but still wonder. And you were a dancer – you don’t say whether you would find sex with unappealing men as equally liberating and well paid.

In this particular case, we have no idea what end of the sex trade this individual was in, nor whether she regarded midwifery as carrying some serious responsibility or as yet another job that allowed her to make money. No matter how liberal or sympathetic one might be to other people’s choices, I don’t think many would regard a side line in prostitution as much of a recommendation.

AmyP

“…nor whether she regarded midwifery as carrying some serious responsibility or as yet another job that allowed her to make money.”

I suspect it being cash, untaxed income had something to do with her interest in both fields.

Renee Martin

THIS^. Both Hb MWery and sex work involve decent sums of cash that is untaxed and easily hidden.
Both also attract people without skills, that want to make money without an investment in time or education. .

Siri

I always say midwifery, not prostitution, is the world’s oldest profession. I mean, the very first prostitute would have had to be born first…

Renee Martin

Agreed, I think it’s an awful idea to be a prostitute, especially if you are presenting yourself as a health care professional. Its illegal, and dangerous. Just because some people manage to do it without self destruction doesn’t make it a wise career choice!

Elizabeth

That’s a pretty far cry from being picked up for prostitution by the Jackson County sheriff. Whatever happened in that situation, I’m sure it involved no PhDs or challenging dance moves. I appreciate the sense of solidarity that motivates you to call yourself and common prostitutes both “sex workers” but on the other hand it trivializes the kind of dysfunction that has to come into a person’s life in order for them to start engaging in sex with a wide variety of strangers in order to keep a roof over her head.

“I think it makes women who couldn’t do the job feel better if they imagine we are all coked out hookers with daddy issues.”

Not as much as it makes those who do sex work feel better to suppose that those of us who don’t do it only make that choice because we “can’t,” as though it were an unequivocal and widespread aspiration. Believe it or not, there are reasons other than not being hawt or fit enough to refrain from displaying one’s body for the entertainment or use of all comers. That such ranking of women comes so naturally to you really gives the lie to the supposed feminist angle on this.

Guestll

Elizabeth, I cannot like your post enough.

I worked in the beer business for six years after business school, and spent 4 out of those 6 years calling on some of the biggest and best known strip bars on the east coast. I spent a considerable amount of time over the years in these venues and while I did meet some dancers who were using the work as a stepping stone to a better life, they were in the minority.

Also, as an aside, I’ve been to Jumbo’s, and most strip bars are categorically not Jumbo’s or Spearmint Rhino’s or any of the other frequently cited places where slumming PhDs and ambitious ballerinas perform — they are fetid and depressing and anonymous.

My personal experience may also be limited, but there are many things I could have done that would’ve made me money while allowing me the opportunity to pursue my goals. None of them involved getting naked and dry humping a stranger in exchange for money in the Champagne Room, yet amazingly, I was able to get where I wanted to be.

Lisa the Raptor

Hey now, I don’t think that’s fair. Feminism, much like freedom of speech is based on women being able to do what they want to do with their lives and bodies, despite what we think of it. I was hoping we were way past the days of a woman choosing to have sex or engage in sexual activity with tens, or even hundreds of men without others saying that there is something wrong with her. On the other hand men still can have sex with hundreds of women and won’t be treated as a broken person who must have had a hard life. Naw, he’s just a playa’. I may not agree with all the things that are said with free speech but I’d fight for the right to say it, just as I may never be in the position to sell my body but I will fight to make sure that a woman can do with her body as she wishes, and that includes having sex for money. It seems we all know at least a few normal, happy women who worked in the sex trade so we do know that there are some out there who are fully aware and happy with their lives. Those are the woman I am talking about, and I don’t approve of the insinuation that they are not feminist or that they are emotionally damaged.

http://www.facebook.com/lizzie.dee.71 Lizzie Dee

Don’t think fair has much to do with it, really. If the attitude and feelings of liberation women get from selling their bodies was shared and respected by those who buy them, I might be a bit more convinced. Do male prostitutes use the same rationale? And is it treated respectfully by either men or women?

Renee Martin

No one respects prostitutes of either gender, nor strippers (though males dancing for females aren’t as hated).

Eddie

| Those are the woman I am talking about, and I don’t approve
| of the insinuation that they are not feminist or that they are
| emotionally damaged.

I don’t believe anyone said, or even intended or insinuated that meaning, that such women are not feminist nor that *all* such women must be emotionally damaged. Also, the discussion wasn’t about the merely promiscuous. It was about those people ** where money changed hands. ** I expect the men in that position are — on average — exactly as damaged as the women. Meaning not 100% of them, obviously, but a large fraction.

Siri

Having sex with lots of men out of choice, because the sex gives you pleasure, is not the same as allowing multiple ‘clients’ the use of your body as a pricier, more enjoyable alternative to masturbation. Enjoyable to them, not you. prostitutes do not, as a rule, enjoy the sex they are paid for. There is nothing feminist about pretending that prostitution can ever be a valid career choice. None of us would like prostitution as a option for our daughters.

theNormalDistribution

It doesn’t matter whether or not prostitutes “enjoy the sex they are paid for”. It is their right to do with their bodies what they choose. There is nothing feminist about telling a woman what she can and can not do with her body.

Siri

I do not believe that ANY women ‘choose’ to sell their bodies; prostitution is yet another symptom of society being anti-woman. Women who have unenjoyable sex in return for money, drugs etc are usually being ‘told’ what to do by a person, or by her circumstances.

Amanda Stamps

Let me guess, you think if ANY woman chooses to be a sex worker, she MUST be a victim of “something” right? Reminds me of the same BS people throw at Kinksters, “Oh how to could you consent to that. I don’t approve so it must be unhealthy and wrong”

Siri

It’s not BS; you show me ANY woman who’d be happy to see her daughter sell her body. It isn’t the same as judging someone’s taste in kinkiness. My daughters can be as kinky as they like (I don’t need to know the details); however, if either of them sold sex, I would see that as a total failure, on my own part and society’s. And an admission of defeat on their own.And don’t get me started on fathers of girls who idolize their princesses but would be happy to pay for sex with other men’s daughters..

Amanda Stamps

Again, it all comes back to people making the assumption that everyone is having the same experience. Are there abused women who are involved in prostitution, yes. That doesn’t mean everyone is abused and drugged out. And yes, it the same as someone throwing the same tired argument at those in any unconventional lifestyle – ” I don’t personally approve of this, so therefore it is wrong for everyone” I don’t buy into the feminist crap, but I do support personal liberty and autonomy. Sex work should be decriminalized, regardless of peoples “moral objection” As long as people are being ethical, safe and responsible (not bringing harm to others, hindering their rights, or harming property) why should it matter if two consenting adults want to exchange sex for money. Frankly, there are some things parents don’t need to know about their adult children, whether they are doing sex work or not, (sex lives period) is one of them. Just my two cents. Boundaries are wonderful things.

Siri

And for every allegedly ‘happy, empowered’ prostitute there are thousands of trafficked, drugged, beaten and abused ‘sex workers’. The quasi-feminist argument that women selling their bodies are actually being strong and liberated is, in fact, misogynistic in the extreme. Sex worker is a euphemism. The realities of sex work are horrendous, for the vast, vast majority. Pretending otherwise is just that, a pretence. And no, I am not a prude, so that won’t wash.

DiomedesV

“I think it makes women who couldn’t do the job feel better if they imagine we are all coked out hookers with daddy issues. Your personal experience is limited.”

By this logic, all female athletes must have immense respect for pole dancers. Not to mention female ballet dancers.

“Your personal experience is limited.”

Ironic, to say the least.

kdgd

so your husband worked int the industry…hypocrisy much? or is it just women in the sex trade who are nuts?

I am a medical practitioner and I know other doctors who did sex work (specifically, prostitution) to support themselves at university. I consider them to be emotionally stable and able to exercise good judgement- and they do so every day, in clinical settings.

I will acknowledge that as prostitution in this country is legal, an Australian healthcare professional engaging in sex work is not the same as a US healthcare professional engaging in sex work, as the Aussie doctor would not be committing a crime (provided that they abided by the relevant legislation).

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, How Your Baby Is Born, an illustrated guide to pregnancy, labor and delivery was published by Ziff-Davis Press in 1994. She can be reached at DrAmy5 at aol dot com...
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